急性心肌梗死患者应用药物涂层球囊的临床研究

Clinical Study of the Application of Drug-Coated Balloons in Patients with Acute Myocardial Infarction

摘要: 目的：药物涂层球囊(DCB)是近年来出现的一种新技术，已被证明是治疗支架内再狭窄的有效和安全的方法。本文的目的是观察DCB治疗急性心肌梗死(Acute myocardial infarction, AMI)的安全性和有效性。方法：从电子病历系统回顾性选取2022年1月至2023年12月于我院接受急诊(Percutaneous coronary intervention, PCI)治疗的急性心肌梗死患者。根据纳排标准进行筛选，选取所有符合纳排标准且应用DCB治疗的患者共115例作为研究组。在全部符合本研究的纳排标准并予以药物洗脱支架(Drug-eluting stent, DES)治疗的患者中随机选取115例，作为对照组。收集两组患者的基线资料及介入治疗特征。随访患者术后1年内主要靶血管失败(Target vessel failure, TVF)的发生率。术后1年复查冠状动脉造影，以了解两组患者的晚期管腔丢失(Late lumen loss, LLL)。结果：随访1年期间，DCB组靶病变的LLL为0.10 ± 0.71 mm，DES组靶病变的LLL为0.26 ± 0.89 mm (P < 0.05)。1年内，DCB组TVF发生率为10.31%，DES组TVF发生率为10.78%。两组间无显著性差异。结论：采用PCI治疗AMI时，采用单纯DCB策略具有不劣于DES的临床疗效，是可靠的替代治疗方法。

Abstract: Objective: Drug-coated balloon (DCB) is a new technology that has emerged in recent years and has been shown to be an effective and safe treatment for in-stent restenosis. The purpose of this article is to observe the safety and efficacy of DCB in the treatment of acute myocardial infarction (AMI). Methods: Patients with acute myocardial infarction who underwent emergency PCI in our hospital from January 2022 to December 2023 were retrospectively selected from the electronic medical record system. Screening was performed according to the criteria, and a total of 115 patients who met the criteria and were treated with DCB were selected as the study group. A total of 115 patients were randomly selected as the control group among all patients who met the criteria for natriuresis and were treated with drug-eluting stents (DES) in this study. Baseline data, interventional characteristics, and medication use were collected from both groups. Patients were followed up for the incidence of major target vessel failure (TVF) within 1 year after the procedure. Coronary angiography was reviewed 1 year after the procedure for late lumen loss (LLL) in both groups. Results: During 1 year of follow-up, the LLL of the target lesion was 0.10 ± 0.71 mm in the DCB group and 0.26 ± 0.89 mm in the DES group (P < 0.05). The incidence of TVF during 1 year was 10.31% in the DCB group and 10.78% in the DES group. There was no significant difference between the two groups. Conclusion: When treating AMI with PCI, the use of DCB-only strategy has a clinical efficacy that is not inferior to DES and is a reliable alternative treatment.