摘要
目的:评价药物涂层球囊(DCB)与药物洗脱支架(DES)对合并2型糖尿病的冠心病患者冠状动脉(冠脉)小血管原位病变的治疗效果。方法:检索2009—2024年PubMed、Cochrane Library、Web of Science、万方数据库、中国知网等相关数据库中DCB与DES对研究人群治疗的文献,最终纳入6篇。对符合纳入排除标准的文献进行Cochrane系统风险偏倚评估和数据提取,采用Rev Man5.4软件进行统计学分析。研究共纳入700例患者(DCB组355例,DES组345例),随访6~36个月,对比术后主要不良心血管事件(MACE)、靶血管血运重建(TVR)、心肌梗死及靶病变晚期管腔丢失(LLL)等情况。结果:与DES相比,DCB可明显降低合并2型糖尿病的冠心病患者术后MACE(OR=0.40,95%CI 0.25~0.64,P<0.01)和TVR(OR=0.25,95%CI 0.13~0.49,P<0.01)的发生率,减少术后心肌梗死发生率(OR=0.35,95%CI 0.15~0.80,P=0.01)及LLL(MD=-0.36,95%CI-0.42~-0.30,P<0.01);但两组术后心源性死亡无明显差异(OR=1.61,95%CI0.62~4.19,P=0.33)。结论:与DES相比,DCB在治疗合并2型糖尿病的冠心病患者冠脉小血管原位病变时可明显改善患者预后。
Objective To evaluate the efficacy of drug-coated balloon(DCB)or drug-eluting stent(DES)in the treatment of small vessels in situ in patients with coronary artery disease(CHD)complicated with type 2 diabetes.Methods Literatures on the treatment of DCB or DES in PubMed,Cochrane library,Web of science,Wanfang Database,CNKI and other relevant databases from 2009 to 2024 were searched,and 6 papers were finally included.Cochrane systematic risk bias assessment and data extraction were performed for literatures that met the inclusion and exclusion criteria,and Rev Man5.4 software was used for statistical analysis.A total of 700 patients(355 in DCB group and 345 in DES group)were included in the study and followed up for 6 to 36 months.Major cardiovascular adverse events(MACE),target vessel revasulation(TVR),myocardial infarction,and late lumen loss(LLL)of target lesions were compared.Results Compared with DES,DCB significantly reduced the incidence of MACE(OR=0.40,95%CI0.25-0.64,P<0.01)and TVR(OR=0.25,95%CI0.13-0.49,P<0.01)in CHD patients with type 2 diabetes.The incidence of postoperative myocardial infarction(OR=0.35,95%CI0.15-0.80,P=0.01)and LLL(MD=-0.36,95%CI-0.42-0.30,P<0.01)were decreased.However,there was no significant difference in postoperative cardiac death(OR=1.61,95%CI0.62-4.19,P=0.33).Conclusion Compared with DES,DCB is effective in the treatment of small vessel in situ lesions in patients with CHD complicated with type 2 diabetes.
作者
孙奕傲然
胡越成
史超阳
SUN Yiaoran;HU Yuecheng;SHI Chaoyang(Tianjin Medical University,Tianjin,300070,China;Clinical School of Thoracic,Tianjin Medical University;Chest Hospital,Tianjin University;Tianjin University Mechanical Engineering)
出处
《临床心血管病杂志》
CAS
2024年第10期811-815,共5页
Journal of Clinical Cardiology
基金
天津市医学重点建设学科(专科)建设项目资助(No:TJYXZDXK-055B)
国家自然科学基金(No:61973231)
河北省自然科学基金(No:E2020202007)
天津市卫生健康科技项目(No:MS20016)。
