糖尿病患者合并冠脉分叉病变药物洗脱球囊扩张术疗效观察

夏屿鸥; 宋耀明

doi:10.16016/j.1000-5404.201808097

您当前的位置：

首页 >

文章列表页 >

糖尿病患者合并冠脉分叉病变药物洗脱球囊扩张术疗效观察

临床医学 | 更新时间：2026-01-09

- 糖尿病患者合并冠脉分叉病变药物洗脱球囊扩张术疗效观察
- Efficacy and safety of drug-eluting balloon dilatation for coronary bifurcation disease in diabetic patients
- 第三军医大学学报 2018年40卷第24期页码：2260-2265
- 作者机构：
  
  400037 重庆, 陆军军医大学(第三军医大学)第二附属医院心血管内科, 全军心血管病研究所
- 作者简介：
  
  [宋耀明, E-mail：sym551342002@yahoo.com.cn SONG Yaoming, E-mail: sym551342002@yahoo.com.cn
- 基金信息：
- DOI：10.16016/j.1000-5404.201808097
  中图分类号： R181.32;R541.405;R587.1
- 收稿：2018-08-14，
  
  修回：2018-10-22，
  
  纸质出版：2018-12-30
- 稿件说明：
移动端阅览
夏屿鸥, 宋耀明. 糖尿病患者合并冠脉分叉病变药物洗脱球囊扩张术疗效观察[J]. 第三军医大学学报, 2018,40(24):2260-2265.

Yuou XIA, Yaoming SONG. Efficacy and safety of drug-eluting balloon dilatation for coronary bifurcation disease in diabetic patients[J]. Journal of Third Military Medical University, 2018, 40(24): 2260-2265.
夏屿鸥, 宋耀明. 糖尿病患者合并冠脉分叉病变药物洗脱球囊扩张术疗效观察[J]. 第三军医大学学报, 2018,40(24):2260-2265. DOI： 10.16016/j.1000-5404.201808097.

Yuou XIA, Yaoming SONG. Efficacy and safety of drug-eluting balloon dilatation for coronary bifurcation disease in diabetic patients[J]. Journal of Third Military Medical University, 2018, 40(24): 2260-2265. DOI： 10.16016/j.1000-5404.201808097.

摘要

目的

观察冠状动脉分叉病变合并糖尿病患者接受紫杉醇药物洗脱球囊(drug eluted balloon

DEB)扩张术后的疗效。

方法

本研究纳入了2016年5月-2017年7月于陆军军医大学(第三军医大学)第二附属医院心血管内科诊断为冠状动脉分叉病变，分支血管行DEB扩张术患者共105例。按照是否合并糖尿病分组，两组患者术后随访第6、9、12个月主要不良心血管事件(包括心绞痛、急性心肌梗死、靶器官血运重建及心源性死亡)的发生情况；术后第12个月复查选择性冠状动脉造影。

结果

两组患者在性别、年龄及冠心病危险因素等临床资料差异均无统计学意义(

0.05)。多因素COX回归模型分析表明：经过1年随访，合并糖尿病与发生主要不良心血管事件(major adverse cardiac events，MACE)之间差异无统计学意义(

=0.235)。两组患者复查选择性冠状动脉造影出现分支血管狭窄数目差异无统计学意义(

0.05)。

结论

合并糖尿病不会增加冠状动脉分叉病变患者行紫杉醇药物洗脱球囊扩张术后出现主要不良心血管事件和血管再狭窄的发生率，该类患者行紫杉醇药物洗脱球囊扩张术安全有效。

Abstract

Objective

To evaluate the efficacy and safety of paclitaxel drug-eluting balloon (DEB) dilatation for treatment of coronary bifurcation disease in patients with diabetes mellitus.

Methods

This study was conducted among 105 patients with coronary artery bifurcation disease undergoing DEB dilation in our department between May

2016 and July

2017. The patients with and without diabetes were compared for major adverse cardiovascular events (MACE; including angina

acute myocardial infarction

target organ revascularization and cardiogenic death) at 6

9 and 12 months following the intervention. At 12 months after surgery

all the patients underwent selective coronary angiography to detect branch stenosis of the coronary artery.

Results

The patients in the diabetic and non-diabetic groups were comparable for gender

age and risk factors of coronary heart disease. Multivariate COX regression model analysis showed no significant correlation between diabetes and MACE at 1 year after the operation (

=0.235). Selective coronary angiography at 1 year after the operation showed no significant difference in the number of stenotic coronary artery branches between the 2 groups (

0.05).

Conclusion

Diabetes does not increase the risks of MACE or coronary artery branch restenosis after DEB dilatation

which is safe and effective for intervention of coronary artery bifurcation disease in diabetic patients.

关键词

Keywords

references

郑凌飞, 韩雅玲, 荆全民, 等. 2型糖尿病与冠状动脉病变程度的相关性分析[J].中国介入心脏病学杂志, 2012, 20(2): 67-71. DOI: 10.3969/j.issn.1004-8812.2012.02.003.

ZHENG L F, HAN Y L, JING Q M, et al. Correlation between type 2 diabetes mellitus and severity of coronary artery stenosis[J]. Chin J Intervent Cardiol, 2012, 20(2): 67-71. DOI: 10.3969/j.issn.1004-8812.2012.02.003.

MESSERLI A, WHAYNE T F JR. Impact of diabetes mellitus on percutaneous coronary intervention outcomes: real-world lessons from a large Chinese single-center registry[J]. Angiology, 2018, 69(9): 749-751. DOI: 10.1177/00033 19717740783.

KIRTANE A J, ELLIS S G, DAWKINS K D, et al. Paclitaxel-eluting coronary stents in patients with diabetes mellitus[J]. J Am Coll Cardiol, 2008, 51(7): 708-715. DOI: 10.1016/j.jacc.2007.10.035.

李文庆, 程志勇, 魏明霞, 等.血管内超声指导介入治疗冠状动脉分叉病变临床研究[J].介入放射学杂志, 2015, 24(4): 292-295. DOI: 10.3969/j.issn.1008-794X.2015.04.004.

LI W Q, CHENG Z Y, WEI M X, et al. Intravascular ultrasound-guided interventional treatment of coronary true bifurcation lesions:a clinical study[J]. J Interv Radiol, 2015, 24(4): 292-295. DOI: 10.3969/j.issn.1008-794X.2015.04.004.

徐佑龙, 刘宗军.药物洗脱球囊在血管介入治疗中的应用[J].心血管病学进展, 2013, 34(3): 408-412. DOI: 10.3969/j.issn.1004-3934.2013.03.030.

XU Y L, LIU Z J. Drug-eluting balloon in treatment of vascular intervention[J]. Adv Cardiovasc Dis, 2013, 34(3): 408-412. DOI: 10.3969/j.issn.1004-3934.2013.03.030.

《中国糖尿病防控专家共识》专家组.中国糖尿病防控专家共识[J].中华预防医学杂志, 2017, 51(1): 12. DOI: 10.3760/cma.j.issn.0253-9624.2017.01.004.

Expert Group of Expert Consensus on China Diabetes Prevention and Control. Expert consensus on China diabetes prevention and control[J]. Chin J Prevent Med, 2017, 51 (1): 12. DOI: 10.3760/cma.j.issn.0253-9624.2017.01.004.

YAHAGI K, KOLODGIE F D, LUTTER C, et al. Pathology of human coronary and carotid artery atherosclerosis and vascular calcification in diabetes mellitus[J]. Arterioscler Thromb Vasc Biol, 2017, 37(2): 191-204. DOI: 10.1161/ATVBAHA.116.306256.

DAEMEN J, GARCIA-GARCIA H M, KUKREJA N, et al. The long-term value of sirolimus- and paclitaxel-eluting stents over bare metal stents in patients with diabetes mellitus[J]. Eur Heart J, 2007, 28(1): 26-32. DOI: 10.1093/eurheartj/ehl412.

BOYDEN T F, NALLAMOTHU B K, MOSCUCCI M, et al. Meta-analysis of randomized trials of drug-eluting stents versus bare metal stents in patients with diabetes mellitus[J]. Am J Cardiol, 2007, 99(10): 1399-1402. DOI: 10.1016/j.amjcard.2006.12.069.

VAN DYCK C J, HOYMANS V Y, HAINE S, et al. New-generation drug-eluting stents: focus on Xience V everolimus- eluting stent and Resolute zotarolimus-eluting stent[J]. J Interv Cardiol, 2013, 26(3): 278-286. DOI: 10.1111/joic.12028.

DE WAHA A, DIBRA A, KUFNER S, et al. Long-term outcome after sirolimus-eluting stents versus bare metal stents in patients with Diabetes mellitus: a patient-level meta-analysis of randomized trials[J]. Clin Res Cardiol, 2011, 100(7): 561-570. DOI: 10.1007/s00392-010-0278-8.

钱惠东, 郑若龙, 李伟章, 等.双支架治疗冠状动脉分叉病变的临床疗效[J].医学临床研究, 2011, 28 (8) : 1514-1517. DOI: 10.3969/j.issn.1671-7171.2011.08.033.

QIAN H D, ZHENG R L, LI WZ, et al. Clinical efficacy of double stents in the treatment of coronary artery bifurcation lesions[J]. Med Clin Stud, 2011, 28(8): 1514-1517. DOI: 10.3969/j.issn.1671-7171.2011.08.033.

GIL R J, BIL J, KERN A, et al. Comparison of dedicated BIOSS bifurcation stents with regular drug-eluting stents for coronary artery bifurcated lesions: pooled analysis from two randomized studies[J]. Cardiol J, 2018, 25(3): 308-316. DOI: 10.5603/CJ.a2017.0098.

CLEVER Y P, CREMERS B, KRAUSS B, et al. Paclitaxel and sirolimus differentially affect growth and motility of endothelial progenitor cells and coronary artery smooth muscle cells[J]. Euro Intervention, 2011, 7(Suppl K): K32-K42. DOI: 10.4244/EIJV7SKA6.

PICARD F, DOUCET S, ASGAR A W. Contemporary use of drug-coated balloons in coronary artery disease: where are we now[J]. Arch Cardiovasc Dis, 2017, 110(4): 259-272. DOI: 10.1016/j.acvd.2017.01.005.

陈韵岱, 王建安, 刘斌, 等.药物涂层球囊临床应用中国专家共识[J].中国介入心脏病学杂志, 2016, 24(2): 61-67. DOI: 10.3969/j.issn.1004-8812.2016.02.001.

CHEN Y D, WANG J A, LIU B, et al. Chinese expert consensus on the clinical application of drug coated balloon[J]. Chin J Intervent Cardiol, 2016, 24(2): 61-67. DOI: 10.3969/j.issn.1004-8812.2016.02.001.

KLEBER F X, SCHULZ A, WALISZEWSKI M, et al. Local paclitaxel induces late lumen enlargement in coronary arteries after balloon angioplasty[J]. Clin Res Cardiol, 2015, 104(3): 217-225. DOI: 10.1007/s00392-014-0775-2.

WONG Y T A, KANG D Y, LEE J B, et al. Comparison of drug-eluting stents and drug-coated balloon for the treatment of drug-eluting coronary stent restenosis: A randomized RESTORE trial[J]. Am Heart J, 2018, 197: 35-42. DOI: 10.1016/j.ahj.2017.11.008.

LIOU K, JEPSON N, CAO C, et al. Drug-eluting balloon versus second generation drug eluting stents in the treatment of in-stent restenosis: a systematic review and meta-analysis[J]. Heart Lung Circ, 2016, 25(12): 1184-1194. DOI: 10.1016/j.hlc.2016.04.001.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

Gm49394对胰岛β细胞凋亡的调控及机制研究

利拉鲁肽通过NOX2调控小胶质细胞/巨噬细胞极化改善糖尿病大鼠脑缺血损伤

内脏脂肪指数与糖尿病前期患者转归糖尿病的相关性研究

空腹血糖受损伴高血压患者5年随访观察胰岛素抵抗的变化

永久、可降解、无聚合物涂层支架在冠状动脉无保护左主干病变介入治疗中的临床分析