【作者】 张帆；

【导师】 贾永平；

【作者基本信息】 山西医科大学 ， 内科学（专业学位）， 2022， 硕士

【摘要】 目的:探究药物涂层球囊(DCB)治疗冠状动脉大血管原位原发病变(denovo病变)的效果分析。方法:回顾性分析104例患者于山西医科大学第一医院行DCB治疗冠状动脉病变并随访复查冠脉造影,分为大血管病变组(32例)和小血管病变组(72例),对2组患者术前临床特征、术中手术情况、术后随访冠脉造影等指标进行分析,研究终点主要不良心血管事件(MACE事件)包括复发心绞痛、急性心肌梗死、严重心律失常、心力衰竭、冠心病死亡等。结果:(1)2组在术前MLD[(0.40±0.18)mm:(0.32±0.12)mm]、术后MLD[(3.31±0.21)mm:(2.72±0.25)mm]、即刻管腔获得[(2.91±0.24)mm:(2.40±0.21)mm]、靶血管分布等方面差异有统计学意义;在性别、年龄、既往史、血糖、肌酐、尿酸等指标无统计学意义。(2)术后随访造影结果MLD[(2.82±0.87)mm:(2.23±0.75)mm]、MACE事件(18%:38.9%)、LVEF[56.5(52.25,64.00)%:61(57.25,64.75)%]等方面差异有统计学意义,在随访时间、晚期管腔丢失(LLL)[(-0.50±0.93)mm:(-0.44±0.73)mm]、LVEDD[51(46.25,53.00)mm:50(47.00,52.00)mm]等方面差异无统计学意义。结论:1.药物球囊置入后,大血管组随访最小管腔直径较小血管组大,晚期管腔丢失2组相似,大血管组左室射血分数较小血管组偏小。2.大血管组总主要不良心血管事件发生率较小血管组小,2组患者在随访期间未见冠心病死亡事件的发生。3.药物涂层球囊治疗冠状动脉大血管原位原发病变是安全有效的,预后效果不劣于小血管病变组。更多还原

【Abstract】 Objective:To investigate the efficacy of drug coated balloon(DCB)in the treatment of coronary Large vessel denovo disease(DENOVO).Methods:Therapeutic effect of drug-coated balloon on primary coronary artery lesion A retrospective analysis was made of 104 patients who received DCB treatment for coronary artery disease in our hospital and were followed up for coronary angiography review.They were divided into large vessel disease group(32 cases)and small vessel disease group(72 cases).Preoperative clinical features,intraoperative conditions,postoperative follow-up coronary angiography and other indicators of the two groups were analyzed.The main adverse cardiovascular events(MACE)included recurrent angina pectoris,acute myocardial infarction,severe arrhythmia,heart failure,coronary heart disease death,etc.Results:(1)preoperative MLD[(0.40±0.18)mm :(0.32±0.12)mm],postoperative MLD[(3.31±0.21)mm :(2.72±0.25)mm],immediate lumen acquisition [(2.91±0.24)mm :(2.40±0.21)mm],target vessel distribution,etc.The difference was statistically significant.There was no statistical significance in gender,age,past history,blood glucose,creatinine,uric acid and other indicators.(2)There were statistically significant differences in MLD[(2.82±0.87)mm:(2.23±0.75)mm],MACE events(18%:38.9%)and LVEF[56.5(52.25,64.00)%: 61(57.25,64.75)%] during postoperative follow-up.There was no significant difference in follow-up time,late lumen loss(LLL)[(-0.50±0.93)mm:(-0.44±0.73)mm] and LVEDD[51(46.25,53.00)mm:50(47.00,52.00)mm].Conclusion:1.After drug balloon implantation,the minimum lumen diameter of the large vessel group was larger in the small vessel group,and the late lumen loss was similar in the two groups.The left ventricular ejection fraction of the large vessel group was smaller in the small vessel group.2.The total incidence of major adverse cardiovascular events in the macrovascular group was lower than that in the vascular group,and no cardiac death events were observed in the 2 groups during follow-up.3.Drug-coated balloon is safe and effective in the treatment of in-situ primary coronary artery lesions of large vessels,and the prognostic effect is not inferior to that of small vessel lesions.更多还原