网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
紫杉醇药物洗脱球囊治疗冠状动脉小血管病变的临床疗效
作者:戴瑞  刘孝钧  梁毅  叶兴  张鸿举 
单位:徐州医科大学附属徐州市立医院 心内科, 江苏 徐州 221000
关键词:介入手术 紫杉醇 药物洗脱球囊 冠状动脉小血管病变 
分类号:R543
出版年·卷·期(页码):2022·50·第十一期(1366-1370)
摘要:

目的:探讨紫杉醇药物洗脱球囊治疗冠状动脉小血管病变的临床疗效。方法:选择2018年6月至2021年6月我院收治的冠状动脉小血管病变患者126例。所有患者根据介入实际情况分成紫杉醇药物洗脱球囊组62例,药物洗脱支架植入组64例。分析两组术前、术后复查冠脉造影病变最小管腔直径、管腔狭窄程度、手术指标及术后9个月心血管和出血不良事件发生率情况。结果:与药物洗脱支架植入组比较,紫杉醇药物洗脱球囊组术后的最小管腔直径长,管腔狭窄程度低,术中小血管病变释放压力小,释放时间长,术后心绞痛和再次狭窄发生率低,差异均有统计学意义(P<0.05)。结论:紫杉醇药物洗脱球囊应用于冠状动脉小血管病变患者的疗效确切,可降低心绞痛发生率,改善血管管腔狭窄程度,且术后不良事件发生较少,是冠状动脉小血管病变患者介入手术的理想方案。

Objective: To investigate the clinical efficacy of paclitaxel drug-eluting balloon in coronary small vessel disease. Methods: 126 patients with coronary small vessel disease treated in our hospital from June 2018 to June 2021 were selected. All patients were divided into paclitaxel drug-eluting balloon group(62 cases) and drug-eluting stent implantation group(64 cases). The minimum lumen diameter, degree of lumen stenosis, surgical indexes and the incidence of adverse cardiovascular and bleeding events 9 months after coronary angiography were analyzed. Results: Compared with drug-eluting stent implantation group,the minimum lumen diameter of paclitaxel drug-eluting balloon group was longer, the degree of lumen stenosis was lower, the release pressure of small and medium-sized vascular lesions was smaller,the release time of small and medium-sized vascular lesions was longer, and The rates of postoperative angina pectoris and restenosis were lower, all the differences had statistically significance(P<0.05). Conclusion: Paclitaxel drug-eluting balloon is effective on patients with coronary small vessel disease. It can reduce the incidence of angina pectoris, improve the degree of vascular stenosis, and have less postoperative adverse events. It is an ideal scheme in patients with coronary small vessel disease.

参考文献:

[1] HER A Y,ANN S H,SINGH G B,et al.Comparison of paclitaxel-coated balloon treatment and plain old balloon angioplasty for de novo coronary lesions[J].Yonsei Med J,2016,57(2):337-341.
[2] 刘志远,张金盈,刘江波,等.经皮腔内冠状动脉成形术联合尿激酶原对急性心肌梗死患者心肌再灌注和预后的影响[J].中国循证心血管医学杂志,2019,11(12):1491-1494.
[3] 刘秀丽,王方明.替格瑞洛对急性心肌梗死患者PTCA支架植入术后血清VCAM-1、ICAM-1及hs-CRP水平的影响[J].国际检验医学杂志,2019,40(17):2088-2091.
[4] 徐苏华.PTCA球囊扩张导管的风险监测分析[J].中国医药报,2019,10(18):1001-1008.
[5] 李蒙,张燕,陈岩,等.药物涂层球囊对冠状动脉左主干分叉病变治疗的临床研究[J].中国循环杂志,2019,34(11):1062-1067.
[6] 柯元南,陈纪林.不稳定性心绞痛和非ST段抬高心肌梗死诊断与治疗指南[J].中华心血管病杂志,2007,35(4):295-304.
[7] 中华医学会心血管病学分会介入心脏病学组.中国经皮冠状动脉介入治疗指南(2016)[J].中华心血管病杂志,2016,44(5):382-400.
[8] 陈韵岱,王建安,刘斌,等.药物涂层球囊临床应用中国专家共识[J].中国介入心脏病学杂志,2016,24(2):61-67.
[9] 曾书燚,王正东,陈坚,等.药物洗脱球囊与药物洗脱支架治疗支架内再狭窄疗效比较[J].介入放射学杂志,2017,26(9):77-80.
[10] 陈庆研,张智勇.冠心病经皮桡动脉穿刺介入治疗疗效及安全性评价[J].中国医学创新,2016,13(34):34-36.
[11] 邓婵翠,邓文文,许官学,等.冠心病PCI术后支架内再狭窄的相关因素分析[J].中国动脉硬化杂志,2017,25(3):278-283.
[12] ELABBASSI W,CHOWDHURY M A,HATALA R,et al.Use of bioresorbable vascular scaffold technology in treating coronary bifurcation lesions:a report about long-termclinical results and review of available literature[J].Bratisl Lek Listy,2019,120(8):545-551.
[13] KANG I S,SHEHATA I,SHIN D H,et al.Comparison between drug coated balloon angioplasty and second generationdrug eluting stent placement for the treatment of in stentrestenosis after drugeluting stent implantation[J].Heart Vessels,2016,31(9):1405-1411
[14] 谢燕青,李伟明.药物涂层球囊在冠状动脉小血管原发病变中的应用进展[J].国际心血管病杂志,2017,44(5):282-284.
[15] 倪忠涵,黄文晖,刘媛,等.紫杉醇洗脱球囊治疗冠状动脉原发病变的安全性和可行性[J].中华心血管病杂志,2018,46(1):39-43.
[16] MURATA N,TAKAYAMA T,HIRO T,et al.Serial observations of Instent restenosis treated with drug coated balloon angio-plasty by optical coherence tomography and coronary angioscopy[J].Int Heart J,2017,58(1):134-139.
[17] 刘蓉,马士新,赵钢,等.紫杉醇药物涂层球囊扩张冠状动脉支架内再狭窄病变增加远期管腔面积[J].介入放射学杂志,2017,26(4):367-369.
[18] BUCCHERI D,PIRAINO D,ANDOLINA G,et al.Understandingand managing instent restenosis:a review of clinicaldata,From pathogenesis to treatment[J].J Thorac Dis,2016,8(10):1150-1162.
[19] 宗雪梅,孙鸿彬,李兵强,等.药物涂层球囊联合切割球囊预扩张在分叉病变中的应用探讨[J].中国循证心血管医学杂志,2018,10(11):1389-1392.
[20] LATIB A,COLOMBO A,CASTRIOTA F,et al.A randomized multi-center study comparing a pacitaxel drug-eluting baloon with a paciaxefeluting stent in smal coronary vossels;the BELLO(Balloon Elution and Late Loss Optimization) study[J].J Am Coll of Cardiol,2012,60(24):2473-2480.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 749760 位访问者


 ©《现代医学》编辑部
联系电话:025-83272481;83272479
电子邮件: xdyx@pub.seu.edu.cn

苏ICP备09058541