摘要
目的:观察药物涂层球囊(DCB)在糖尿病(DM)患者冠状动脉小血管病变应用中的有效性及近期疗效。方法:入选DM冠状动脉小血管病变患者39例,均单独应用DCB治疗,记录治疗前后最小管腔直径(MLD)、手术即刻成功率及主要不良心血管事件(MACE)发生率。6个月后复查冠状动脉造影,观察靶血管MLD,计算晚期管腔丢失(LLL)。结果:39例患者共46处病变接受DCB治疗,DCB扩张后,1处病变管壁急性弹性回缩,2处病变出现C型夹层,给予补救性置入药物洗脱支架(DES),手术即刻成功率93.48%,术后即刻MLD较术前显著增加(1.64±0.38)mm对(0.92±0.43)mm,P<0.01,所有患者随访期间无死亡、心肌梗死事件发生。术后6个月28例患者复查冠状动脉造影,2例发生较明显的再狭窄,其中1例置入DES,1例再次给予DCB扩张治疗,复查造影患者的MLD为(1.46±0.32)mm,LLL为(0.18±0.31)mm。按靶血管部位分别计算,6个月后与术后即刻MLD比较,差异无统计学意义;按总体靶血管计算,差异有统计学意义(P<0.05)。结论:DCB可显著增加DM患者冠状动脉小血管病变管腔直径,LLL较少,且耐受性好,无异物置入,即刻及短期疗效肯定。
Objective:To investigate the short-term efficacy of using drug-coated balloon(DCB)to treat small vessel coronary artery disease in patients with diabetes.Methods:A total of 39 diabetic patients with small vessel coronary artery disease were included and treated with DCB alone.Minimal luminal diameter(MLD)before and after treatment,immediate success rate,and the incidence of major adverse cardiovascular events(MACE)within 6 months after surgery were recorded.Repeat angiography was performed at 6 months to evaluate the MLD and late lumen loss(LLL)in target vessel.Results:Thirty-nine patients with 46 lesions were treated with DCB.Acute elastic recoil was observed in one lesion,and 2 bailout drug-eluting stents were used because of C type coronary dissection.The immediate success rate was 93.48%.MLD improved from(0.92±0.43)mm at baseline to(1.64±0.38)mm immediately after balloon dilation(P<0.01).There was no death and miocardial infarction during follow up.A total of 28 patients received angiography at 6 months after operation,among which 2 patients had significant restenosis and treated with DES and repeated DCB,respectively.The MLD was(1.46±0.32)mm and the LLL was(0.18±0.31)mm.There was no statistically significant difference in MLD calculated according to different target vessel between 6 months later and immediately after surgery.But the difference was statistically significant in terms of MLD calculated from all the vessels(P<0.05).Conclusions:DCB can significantly increase the lumen diameter of small coronary vessel in diabetic patients,with less LLL,good tolerance,no foreign body implantation and positive immediate and short-term efficacy.
作者
谢江波
温燕华
衷涛
何涛
李良
祝文涛
李顺辉
XIE Jiangbo;WEN Yanhua;ZHONG Tao;HE Tao;LI Liang;ZHU Wentao;LI Shunhui(Department of Cardiology,the Third Affiliated Hospital of Nanchang University,Jiangxi 330008,China)
出处
《国际心血管病杂志》
2019年第5期297-300,共4页
International Journal of Cardiovascular Disease
基金
江西省卫生计生委科技计划项目(20187017)
