药物涂层球囊治疗糖尿病膝下动脉病变的疗效与安全性研究-现代医学

药物涂层球囊治疗糖尿病膝下动脉病变的疗效与安全性研究

单位：1. 邯郸市第一医院内分泌一科, 河北邯郸 056000;
2. 邯郸市第一医院呼吸二科, 河北邯郸 056000;
3. 河北医科大学第四医院内分泌科, 河北石家庄 050035;
4. 邯郸市第一医院心内二科, 河北邯郸 056000

关键词：药物涂层球囊血管成形术糖尿病膝下动脉硬化闭塞症

分类号：R654.3

出版年·卷·期（页码）：2020·39·第六期（695-699）

摘要：

目的： 探究药物涂层球囊（DCB）治疗糖尿病膝下动脉病变的疗效与安全性。方法： 选取2015年1月至2017年11月邯郸市第一医院糖尿病膝下动脉硬化闭塞症患者84例（患肢92条），分为行经皮腔内血管成形术（PTA）治疗组51例（患肢53条）与DCB治疗组33例（患肢39条）；治疗后随访6个月，记录两组患者的动脉闭塞情况、踝肱指数（ABI）、Rutherford分级、晚期管腔丢失（LLL）、再狭窄率、靶病变血运重建（TLR）发生率及不良反应的发生情况。结果： 随访6个月，所有患者未发生死亡，随访率100%；与治疗前比较，治疗后DCB组Rutherford分级情况与PTA组无明显差异（P>0.05），ABI、动脉狭窄程度、TLR发生率、再狭窄率和LLL值比较，DCB组均显著优于PTA组（P<0.05）；术后小腿疼痛、肿胀、术后6个月继发性血栓及肢体截肢发生率比较，PTA组总发生率为15.09%，与DCB组的10.26%相较，差异无统计学意义（P>0.05）。结论： DCB在糖尿病下肢动脉病变治疗中效果较好，降低再狭窄率、TLR发生率，值得临床推广。

Objective: To investigate the efficacy and safety of drug-coated balloon(DCB) on the treatment of diabetic inferior genicular artery disease.Methods: 84 patients with diabetic inferior genicular arteriosclerosis obliterans in Handan First Hospital from January 2015 to November 2017 were selected, which were divided into treatment group of the percutaneous transluminal angioplasty(PTA), included 51 patients with 53 affected limbs and treatment group of DCB included 33 patients with 39 affected limbs. After 6 months, the arterial occlusion, ankle-brachial index(ABI), Rutherford classification, late lumen loss(LLL), restenosis rate, target lesion revascularization(TLR) incidence and adverse reactions of the two groups were recorded.Results: After 6 months of follow-up, all patients did not die and the follow-up rate was 100%. There was no significant difference in Rutherford grade between the DCB group and the PTA group after treatment compared with that of pretreatment(P>0.05). ABI, degree of arterial stenosis, incidence of TLR, restenosis rate and LLL value of DCB treatment group were significantly better than those of PTA group(P<0.05). Compared with 10.26% in DCB group, the total incidence rate of the leg pain, swelling, secondary thrombosis and limb amputation in PTA group was 15.09%.However, there were no significant differences between the two groups(P>0.05).Conclusion: DCB is effective in the treatment of diabetic lower extremity arteriopathy, which could reduce the restenosis rate and TLR incidence. It is worthy of clinical promotion.

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