摘要
目的评价药物涂层球囊在冠状动脉粥样硬化性心脏病(冠心病)患者冠状动脉(冠脉)原位大血管病变中应用的临床效果。方法回顾性分析2015年10月至2018年4月期间于北京大学首钢医院心内科住院的冠心病患者,冠脉造影检查存在冠脉原位病变,并行药物涂层球囊治疗的患者共184例,按照患者冠脉病变参考血管直径分为两组:大血管组(n=54,2.75 mm<D≤3.5mm)及小血管组(n=130,D≤2.75 mm),并在治疗后4~9个月复查冠脉造影。比较两组间晚期管腔丢失及6个月的主要不良心血管事件(MACE)事件。结果两组患者基线资料无差异(P>0.05)。大血管组和小血管组患者冠脉病变治疗前最小管腔直径分别为(1.07±0.47)mm及(0.78±0.39)mm,P<0.01;治疗后血管直径分别为(3.08±0.24)mm、(2.29±0.32)mm,P<0.01;即刻获得管腔直径分别为(2.02±0.52)mm、(1.51±0.42)mm,P<0.01;复查造影时最小管腔直径分别为(3.00±0.41)mm、(2.23±0.37)mm,P<0.01,晚期管腔丢失分别为0.06(0.03,0.10)mm、0.04(0.01,0.11)mm,P=0.94;两组患者随访6个月时大血管组不稳定性心绞痛1例,死亡1例,小血管组无MACE发生,两组患者MACE事件发生率无统计学差异(P<0.05)。结论大血管组与小血管组冠脉病变晚期管腔丢失及6月随访MACE事件相似,药物涂层球囊可在冠脉原位大血管病变中进一步探索性应用。
Objective To evaluate the clinical effect of drug-coated balloons on coronary artery in situ macrovascular disease in patients with coronary heart disease.Methods We retrospectively studied 184 patients with de novo lesions in coronary heart disease patients who underwent coronary angiography and were treated with parallel drug-coated balloon in the Department of Cardiology of Peking University Shougang Hospital from October 2015 to April 2018.The patients were divided into two groups according to the reference vessel diameter:the large vessel group(n=54,3.5 mm≥D>2.75 mm)and the small vessel group(n=130,D≤2.75 mm).Followup coronary angiography was performed in 4 to 9 months for all the patients.The late lumen loss and the major adverse cardiovascular events(MACE)between the two groups were compared.Results There was no difference in baseline data between the two groups of patients(P>0.05).The minimum lumen diameter of patients with large vessel group and small vessel group before treatment of coronary artery disease was(1.07±0.47)mm and(0.78±0.39)mm(P<0.01);the diameter of blood vessels after treatment was(3.08±0.24)mm,(2.29±0.32)mm(P<0.01);the luminal diameters obtained immediately were(2.02±0.52)mm and(1.51±0.42)mm(P<0.01);the minimum luminal diameters were(3.00)during re-examination±0.41mm,(2.23±0.37)mm(P<0.01),the late lumen loss was 0.06(0.03,0.10)mm and 0.04(0.01,0.11)mm(P=0.94).One patient with unstable angina pectoris in the large vessel group and one death in the two groups were followed up for 6 months.There was no MACE in the small vessel group,and there was no statistical difference in the incidence of MACE events between the two groups of patients(P<0.05).Conclusion In the large-vessel group and the small-vessel group,the late luminal loss of coronary artery disease and the follow-up MACE events were similar.The drug-coated balloon could be further explored for coronary artery in situ macrovascular disease.
作者
刘坤
王智
史震涛
姜浩
唐强
Liu Kun;Wang Zhi;Shi Zhentao;Jiang Hao;Tang Qiang(Department of Cardiology,Peking University Shougang Hospital,Beijing 100144,China)
出处
《中国循证心血管医学杂志》
2020年第2期210-213,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
