药物涂层球囊在冠状动脉大血管原位及长病变中的应用

目的：评价药物涂层球囊（DCB）在治疗冠状动脉大血管原位病变（冠状动脉病变参考直径≥2.8 mm）以及大血管原位长病变（冠状动脉病变参考直径≥2.8 mm，病变长度≥20 mm）中的临床疗效。方法：选取2015年4月至2020年12月在杭州师范大学附属医院心内科诊治的患者80例，均为给予DCB治疗的冠状动脉大血管原位原发病变。采用计算机定量冠脉造影分析软件（QCA）分别对所纳入患者术前、术后即刻及随访三个不同时刻的冠脉造影图像进行分析，评估DCB的疗效；将入选的患者按照靶血管病变长度分成2组，即病变长度＜20 mm组（n =45）和病变长度≥20 mm组（n =35），评估DCB治疗冠脉大血管原位长病变的疗效。结果：所纳入病例靶血管的病变长度为（15.71±5.98）mm，参考直径为（3.22±0.34）mm，在（15.89±9.34）个月的随访时间里，无患者发生急性心肌梗死、严重心律失常、心源性死亡及卒中。所有随访患者中未出现再次靶血管病变血运重建病例，随访时的晚期管腔丢失为（-0.01±0.26）mm。不同病变长度组患者晚期管腔丢失差异无统计学意义（0.003±0.3）mm vs.（ -0.03±0.23）mm，P =0.615]。结论：DCB治疗冠状动脉大血管原位病变及原位长病变安全、有效，并能减少冠脉靶病变的晚期管腔丢失。

The application of drug-coated balloon in in situ and long lesions of large vessels in coronary arteries

Objective: To observe the efficacy of drug-coated balloon (DCB) in the treatment of large vessels in situ (reference diameter≥2.8 mm) and in situ long lesions (reference diameter≥2.8 mm, length≥20 mm) of large vessels in coronary arteries. Methods: A total of 80 patients who were diagnosed and treated in the Department of Cardiology, Affiliated Hospital of Hangzhou Normal University from April 2015 to December 2020 were selected, who were all treated with DCB for in situ primary coronary artery lesions. Computer quantitative coronary angiography analysis software was used to analyze the coronary angiography images of the included patients at three different times: before operation, immediately after operation and follow-up. The selected patients were divided into two groups according to the length of target vessel lesions, namely the lesion length <20 mm group (n=45) and the lesion length≥20 mm group (n=35). The inter-group comparison was performed to evaluate the efficacy of DCB in long in situ coronary artery lesions. Results: The average length of target vessel lesion of the included cases was (15.71±5.98) mm, and the reference diameters was (3.22±0.34) mm. During the follow-up of (15.89±9.34) months, no patients had acute myocardial infarction or severe arrhythmia, cardiogenic death or stroke. There were no cases of revascularization of target vessel in all follow-up patients, and the late lumen loss during follow-up was (-0.01±0.26) mm. There was no significant difference in late lumen lossbetween the two groups of patients with different lesion lengths (0.003±0.3) mm vs. (-0.03±0.23) mm, P=0.615]. Conclusion: DCB is safe and effective in the treatment of in situ and long lesions of large vessels in coronary arteries and it can reduce the late lumen loss of coronary target lesions.