摘要：
目的 研究药物涂层球囊治疗高出血风险急性冠脉综合征患者的疗效及安全性.方法 对2017年3月至12月共10个月在我院治疗的高出血风险的急性冠脉综合征患者进行回顾性分析,其中入选病例单纯普通球囊扩张为对照组,药物涂层球囊(DCB)治疗为试验组,对两组患者年龄、术后3个月内的主要心脏不良事件(MACE)、致死性出血事件、全因死亡率、归因死亡率,靶病变血运重建率(TLR)、介入治疗前狭窄程度、治疗后即刻狭窄程度及治疗后3个月的狭窄程度等进行统计分析. 结果 研究中两组患者术后3个月内的MACE发生率(25.0％比6.7％,x2 =2.03,P=0.15)、致死性出血事件发生率(10％比6.7％,x2=0.12,P=0.727)、全因死亡率(20.0％比6.7％,x2=1.24,P=0.27)、归因死亡率(10.0％比0.0％,x2=1.59,P=0.21),TLR(14.3％比0.0％,x2 =3.08,P=0.08)均未见统计学差异,但试验组致死性出血事件发生率、MACE发生率、全因死亡率、归因死亡率、靶病变血运重建率均较低. 结论 药物涂层球囊治疗高出血风险的急性冠脉综合征患者安全有效.%Objective To evaluate the efficacy and safety of paclitaxel drug-coated balloons (DCB)in treating acute coronary syndrome in patients with high bleeding risk.Methods A total of 35 inpatients with acute coronary syndrome and high bleeding risk who were treated in our hospital from March 2017 to December 2017 were retrospectively analyzed.The patients were divided into the control group (n=20) treated with normal balloon dilatation and the experimental group (n =15) treated with DCB treatment.The age,major cardiac adverse events(MACE)within 3 months,fatal hemorrhage events,all-cause mortality,attributable mortality,target lesion revascularization rate(TLR),coronary artery stenosis degree before intervention,and coronary artery stenosis degree at once and 3 months after surgery,were used for comparison and for statistical analysis between the control and the experimental group.Results There were no significant differences between the two groups in the indexes as the followings:MACE within 3 months after surgery(25.0％ vs.6.7％,x2 =2.03,P =0.15),fatal hemorrhage events (10.0 ％ vs.6.7 ％,x2 =0.12,P =0.727),all-cause mortality (20.0％ vs.6.7％,x2 =1.24,P =0.27),attributable mortality(10.0％ vs.0.0％,x2 =1.59,P=0.21),TLR(14.3％ vs.0％,x2 =3.08,P =0.08).However,the incidence of fatal hemorrhage and MACE,all-cause mortality,attributable mortality and TLR were relative low in the experimental group (P＞0.05).Conclusions Drug-coated balloon treatment is safe and effective in treating acute coronary syndrome in patients with high bleeding risk.
