药物涂层球囊在冠状动脉小血管病变患者中的临床应用价值

摘要

目的:探讨药物涂层球囊(DCB)在冠状动脉小血管病变(SVD)患者中的临床应用价值.方法:选择在我院接受治疗的SVD患者140例,根据采用的不同治疗方案分为 DCB组(60例)和药物洗脱支架(DES)组(80例) ,详细记录SVD患者的临床特征、双抗血小板治疗情况、 1年后临床结果,并进行1年后SVD患者主要心脏不良事件的多因素Logistic回归分析.结果: 1年后,两组患者在全因死亡、心肌梗死、靶病变血运重建、脑血管意外、晚期管腔丢失和靶病变再次狭窄发生率方面差异不显著(P均＞0.05).糖尿病、高脂血症、急性冠状动脉综合征是影响1年后SVD患者主要心脏不良事件的独立危险因素(OR＝1.093～1. 125 , P＜ 0. 05或＜0. 01 ) .随访期间两组SVD患者累积生存率比较无显著性差异(P＞0.05).结论:在治疗冠状动脉小血管病变患者中,药物涂层球囊是一个安全、有效、可行的替代治疗方法.%Objective :To explore clinical application value of drug-coated balloon (DCB) in patients with coronary ar-tery small vascular disease (SVD).Methods :A total of 140 SVD patients treated in our hospital were selected .Ac-cording to therapeutic plan ,they were divided into DCB group (n＝60) and drug-eluting stent (DES) group (n＝80).Clinical features ,dual-antiplatelet treatment condition and clinical outcome after one year were recorded in de- tail .Multi-factor Logistic regression analysis was used to analyze influencing factors for major adverse cardiovascular events (MACE) in SVD patients on one year .Results :After one year ,there were no significant difference in inci-dence rates of all-cause death ,myocardial infarction ,target lesion revascularization ,cerebrovascular accident ,late lumen loss and target lesion restenosis between two groups , P＞0.05 all.Diabetes mellitus ,hyperlipidemia and acute coronary syndrome were independent risk factors for MACE in SVD patients after one year (OR＝1.093～1.125 , P＜0.05 or ＜0.1).There was no significant difference in cumulative survival rate between two groups during fol-low-up , P＞0. 05. Conclusion : DCB is a safe ,effective and feasible alternative method in the treatment of patients with coronary artery small vascular disease .