2019 年第 10 期 第 14 卷

药物涂层球囊在冠状动脉小血管病变和支架内再狭窄中的临床应用

Clinical application of drug-coated balloon in coronary small vessel disease and in-stent restenosis

作者：李宁顾伟阴赪茜孙涛李志忠

英文作者：

单位：100029首都医科大学附属北京安贞医院心内科

英文单位：

关键词：冠状动脉小血管病变；支架内再狭窄；药物涂层球囊；药物洗脱支架

英文关键词：

• 摘要：

• 【摘要】目的    观察药物涂层球囊（DCB）在冠状动脉小血管病变和支架内再狭窄(ISR)中的临床应用效果。方法    连续性纳入2017年9月至2019年1月于首都医科大学附属北京安贞医院心血管内科行DCB治疗的患者共42例为DCB组，其中ISR 18例，冠状动脉小血管病变24例，另选取同一时间段内性别、年龄、病变血管相匹配的行药物洗脱支架（DES）治疗的患者42例作为DES组。随访观察患者主要心血管不良事件发生情况和冠状动脉造影或冠状动脉CT血管成像复查情况。结果    2组患者平均随访（11±4）个月，均未发生心源性死亡和急性心肌梗死，2组患者靶血管血运重建、靶病变血运重建、非靶血管血运重建、心绞痛再发发生率比较，差异均无统计学意义（均P＞0.05）。DCB组随访中获得了19例（17例冠状动脉造影，2例冠状动脉CT血管成像）复查结果，平均复查时间为术后（8±5）个月，其中ISR 6例，全部通畅；冠状动脉小血管病变13例，其中2例出现严重狭窄（狭窄程度＞70%）。DES组中2例（ISR 1例，冠状动脉小血管病变1例）复查冠状动脉造影出现严重狭窄,复查时间为术后6个月，狭窄程度均为90%。结论    DCB治疗冠状动脉小血管病变和ISR的临床效果较好。

• 【Abstract】Objective    To observe the clinical effect of drug-coated balloon（DCB） on coronary small vessel disease and in-stent restenosis(ISR). Methods    From September 2017 to January 2019, 42 consecutive patients undergoing DCB treatment in Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University were enrolled in DCB group, including 18 cases of ISR and 24 cases of coronary artery small vessel disease. Another 42 patients matched by sex, age and culprit vessel undergoing drug-eluted stent(DES) treatment were enrolled as DES group. Occurrence of major adverse cardiovascular events and reexamination results of coronary angiography or coronary CT angiography were observed during follow-up. Results    The average follow-up period was （11±4）months. No cardiogenic death or acute myocardial infarction occurred. There were no significant differences in target vessel revascularization, target lesion revascularization, non-target vessel revascularization and angina recurrence rates between DCB group and DES group(all P＞0.05). In DCB group, 19 patients had valid follow-up data of coronary angiography(17 cases) or coronary CT angiography(2 cases); the average reexamination time was （8±5）months. Among them, 6 cases of ISR showed satisfactory patency; 2 in 13 cases of coronary small vessel disease developed severe stenosis(＞70%). In DES group, 2 patients(1 case of ISR and 1 case of coronary small vessel disease) developed severe stenosis（90%） noticed by coronary angiography at 6 months after operation. Conclusion    Clinical effects of DCB on coronary small vessel disease and ISR are satisfactory.