药物涂层球囊扩张与经皮腔内球囊扩张合并支架植入术对下肢动脉硬化闭塞病变患者治疗的各项临床指标的影响

doi:10.3969/j.issn.1006-6233.2022.06.018

摘要
图/表
参考文献
相关文章 (1)

全文: PDF (1240 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 研究药物涂层球囊扩张(DCB)与经皮腔内球囊扩张合并支架植入术治疗下肢动脉硬化闭塞病变(LEAOD)的效果。方法: 采用回顾性分析方法,研究对象为2017年3月至2022年2月入院的88例LEAOD患者,根据治疗方式不同分为研究组(44例)与对照组(44例),研究组行DCB治疗,必要时行补救性支架植入术;对照组行经皮腔内球囊扩张合并支架植入术治疗;比较两组临床指标“晚期管腔丢失(LLL)值、下肢动脉狭窄程度、下肢动脉最小管腔直径(MLD)、踝肱指数(ABI)”及术后恢复情况(恶性事件发生率、靶病变血管血运重建率、再狭窄率、Rutherford分级)。结果: 两组术后首日ABI差异无统计学意义(P>0.05);两组术后3个月ABI高于术后首日,且研究组术后3个月较对照组更高,差异有统计学意义(P<0.05)。两组术后首日LLL值、下肢动脉狭窄程度、MLD差异无统计学意义(P>0.05);两组术后3个月LLL值、下肢动脉狭窄程度、MLD低于术后首日,且研究组术后3个月LLL值、下肢动脉狭窄程度较对照组更低,下肢动脉MLD更高,差异均有统计学意义(P<0.05)。两组术后3个月恶性事件发生率差异无统计学意义(P>0.05);研究组术后3个月靶病变血管血运重建率、再狭窄率及utherford分级≤3级率更低,差异均有统计学意义(P<0.05)。结论: DCB用于LEAOD治疗中效果显著,可进一步改善患者动脉狭窄,提升ABI值,加速下肢动脉血流恢复,减少再狭窄与恶性事件。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	张恺欣
	张明
	陈军
	王硕

关键词 ：下肢动脉硬化闭塞病变, 支架植入术, 经皮腔内球囊扩张, 药物涂层球囊扩张, 下肢动脉狭窄

Abstract：Objective: To study the effect of drug-coated balloon dilation (DCB) and percutaneous intraluminal balloon dilation combined with stent implantation in the treatment of lower extremity arteriosclerosis occlusive lesions (LEAOD). Methods: A retrospective analysis was performed on 88 patients with LEAOD admitted from March 2017 to February 2022, who were divided into study group (44 cases) and control group (44 cases) according to different treatment methods. The study group was treated with DCB and remedial stenting if necessary; the control group was treated with percutaneous intracavitary balloon dilation combined with stenting. The clinical indicators of "late lumen loss (LLL) value, degree of lower limb artery stenosis, minimum lumen diameter of lower limb artery (MLD), ankle-brachial index (ABI)" and postoperative recovery (incidence of malignant events, revascularization rate of target lesion vessels, restenosis rate, Rutherford grade) were compared between the two groups. Results: The difference in ABI between the two groups on the first day after surgery was not statistically significant (P>0.05); the ABI at 3 months after surgery was higher than that on the first day after surgery in both groups, and the difference was higher in the study group at 3 months after surgery compared with the control group (P<0.05). The differences in LLL values, lower limb artery stenosis and MLD on the first day after surgery were not statistically significant between the two groups (P>0.05); LLL values, lower limb artery stenosis and MLD at 3 months after surgery were lower than on the first day after surgery in both groups, and LLL values and lower limb artery stenosis were lower and lower limb artery MLD was higher in the study group than in the control group at 3 months after surgery, and the differences were statistically significant (P<0.05). The LLL values, lower limb artery stenosis and MLD at 3 months after surgery were lower than those at the first postoperative day in both groups, and the LLL values and lower limb artery stenosis at 3 months after surgery were lower and the lower limb artery MLD was higher in the study group than in the control group, and the differences were statistically significant (P<0.05). There was no statistically significant difference in the incidence of malignant events between the two groups at 3 months postoperatively (P>0.05); the rate of revascularisation of the target lesion, the rate of restenosis and the rate of uterford classification ≤3 were lower in the study group at 3 months postoperatively, all with statistically significant differences (P<0.05). Conclusion: DCB has been shown to be effective in the treatment of LEAOD, further improving arterial stenosis, raising ABI values, accelerating restoration of lower limb arterial flow and reducing restenosis and malignant events

Key words： Lower limb arteriosclerosis occlusive lesions Stent implantation Percutaneous intraluminal balloon dilation Dilation of drug-coated balloon Lower extremity artery stenosis

基金资助:江苏省科技厅基金项目,(编号:2019KJ01375)

通讯作者: 张明

引用本文:

张恺欣, 张明, 陈军, 王硕. 药物涂层球囊扩张与经皮腔内球囊扩张合并支架植入术对下肢动脉硬化闭塞病变患者治疗的各项临床指标的影响[J]. 河北医学, 2022, 28(6): 960-963.
ZHANG Kaixin, ZHANG Ming, CHEN Jun, et al. Effects of Drugcoated Balloon Dilation and Percutaneous Intraluminal Balloon Dilation Combined with Stent Implantation on Clinical Indexes of Patients with Lower Extremity Arteriosclerosis Occlusive Lesions. HeBei Med, 2022, 28(6): 960-963.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.06.018 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I6/960

[1] 郑月宏,宋希涛.下肢动脉硬化闭塞症治疗进展与展望[J].中华外科杂志,2021,59(12):961-964.
[2] Fowkes,F,G,et al.Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010:a systematic review and analysis[J].Lancet London,2013,382(9901):1329-1340.
[3] 赵翼,原野,刘辉,等.腔内血管成形术治疗老年人下肢动脉硬化闭塞症临床疗效及安全性评价[J].北华大学学报(自然科学版),2018,19(1):68-72.
[4] 徐义岩,王海洋.下肢动脉硬化闭塞症的治疗进展[J].医学综述,2020,26(24):4892-4895,4900.
[5] 赵文鲁.紫杉醇药物涂层球囊对下肢动脉硬化闭塞症患者临床疗效的观察[J].齐齐哈尔医学院学报,2021,42(21):1864-1867.
[6] 宋涛,孙勇,聂中林,等.药物涂层球囊与普通球囊治疗下肢动脉硬化闭塞症支架置入术后支架内再狭窄的疗效对比[J].中华普通外科杂志,2021,36(5):350-354.
[7] 曾仲衍,李嘉宏,黄敏捷,等.下肢动脉硬化闭塞经介入治疗后再狭窄的危险因素分析[J].福建医药杂志,2020,42(2):51-55.
[8] Scheinert D,Duda S,Zeller T,et al.The LEVANT I (Lutonix paclitaxel-coated balloon for the prevention of femoropopliteal restenosis) trial for femoropopliteal revascularization:first-in-human randomized trial of low-dose drug-coated balloon versus uncoated balloon angioplasty.[J].JACC:Cardiovascular Interventions,2014,7(1):10-19.
[9] Uhlemann M,S Mobius-Winkler,Adam J,et al.The leipzig prospective drug-eluting balloon-registry - outcome of 484 consecutive patients treated for coronary in-stent restenosis and de novo lesions using paclitaxel-coated balloons[J].Circulation Journal Official Journal of the Japanese Circulation Society,2015,80(2):379-386.
[10] 赵旭,任昊,王刃.药物涂层球囊经皮腔内血管成形术治疗下肢动脉硬化闭塞症的临床效果[J].中国现代医生,2021,59(14):66-69.