血管内超声预测药物球囊致冠状动脉夹层的影响因素
The influencing factors of coronary artery dissection caused by drug balloons under intravascular ultrasound
韩彬 1徐亚威 1刘艳艳 1许浩杰 1孟圆 1杨海波1
作者信息
- 1. 郑州大学第一附属医院心血管内科(郑州,450052)
- 折叠
摘要
目的:探究在血管内超声(intravascular ultrasound,IVUS)辅助下药物涂层球囊(drug-coated bal-loon,DCB)处理冠状动脉(冠脉)原位病变出现冠脉夹层的影响因素.方法:收集2020年1月—2021年6月于郑州大学第一附属医院在IVUS辅助下DCB处理冠脉原位病变患者的临床资料及影像资料进行回顾性分析.根据IVUS下是否观察到冠脉夹层,分为夹层组和无夹层组,使用logis tic回归分析夹层的影响因素.结果:共纳入患者99例,其中夹层组较非夹层组有更长的药物球囊长度(30.33 mm vs 22.17 mm,P＜0.05),更大的预扩球囊直径/IVUS下病变部位直径(0.92 vs 0.81,P＜0.05)和药物球囊直径/IVUS下病变部位直径(0.95 vs 0.88,P＜0.05),更低的左心室射血分数(58.23％vs 62.15％,P＜0.05),更小的管腔面积(2.74 mm2 vs 3.61 mm2,P＜0.05)和平均管腔中膜面积(11.53 mm2 vs 16.79 mm2,P＜0.05).多因素logistic回归分析结果显示,最小管腔面积(OR=0.498,95％CI:0.270～0.919,P=0.026)、平均管腔中膜面积(OR=0.854,95％CI:0.732～0.997,P=0.046)、药物球囊长度(OR=1.084,95％CI:1.003～1.171,P=0.041)、最大预扩球囊直径/IVUS下病变部位直径(OR=166.968,95％CI:1.712～16 286.265,P=0.029)是夹层发生的影响因素.结论:药物球囊长度、最大预扩球囊直径/IVUS下病变部位直径是DCB处理原位病变冠脉夹层发生的独立危险因素,病变部位最小管腔面积、平均管腔中膜面积是DCB处理原位病变冠脉夹层发生的保护因素.
Abstract
Objective:To explore the influencing factors of coronary artery dissection in the treatment of de no-vo coronary artery disease with drug-coated balloons under intravascular ultrasound(IVUS)guidance.Methods:Clinical and imaging data of patients treated with DCB for de novo coronary artery disease under IVUS guidance at the First Affiliated Hospital of Zhengzhou University from January 2020 to June 2021 were retrospectively ana-lyzed.According to the presence or absence of coronary artery dissection observed under IVUS,the patients were divided into the dissection group and non-dissection group,and multiple logistic regression analysis was used to analyze the influencing factors of dissection.Results:A total of 99 patients were included.Compared with the non-dissection group,the dissection group had a greater drug balloon length(30.33 mm vs 22.17 mm,P＜0.05),bigger pre-dilation balloon diameter/lesion site diameter under IVUS(0.92 vs 0.81,P＜0.05),and bigger drug balloon diameter/lesion site diameter under IVUS(0.95 vs 0.88,P＜0.05).In addition,the dissection group had a lower left ventricular ejection fraction(58.23％vs 62.15％,P＜0.05),smaller lumen area(2.74 mm2 vs 3.61 mm2,P＜O.05),and smaller average external elastic membrane cross-sectional area(11.53 mm2 vs 16.79 mm2,P＜0.05).The results of multiple logistic regression analysis showed that minimum lumen area(OR=0.498,95％CI 0.270-0.919,P=0.026),average external elastic membrane cross-sectional area(OR=0.854,95％CI 0.732-0.997,P=0.046),drug-coated balloon length(OR=1.084,95％CI 1.003-1.171,P=0.041),and the ratio of the maximum pre-dilation balloon diameter to the diameter of the lesion site under IVUS(OR=166.968,95％CI 1.712-16 286.265,P=0.029)were associated with the occurrence of dissection.Conclusion:The length of the drug-coated balloon and the ratio of the maximum pre-dilation balloon diameter to the diameter of the lesion site under IVUS are independent risk factors for dissection in treating de novo coronary artery disease with the drug-coated balloon.The minimum lumen area and average external elastic membrane area of the lesion site are protective factors for dissection in treating de novo coronary artery disease with drug-coated balloon.
关键词
药物球囊/原位病变/血管内超声/冠状动脉夹层Key words
drug-coated balloon/de novo coronary lesions/intravascular ultrasound/coronary artery dissection引用本文复制引用
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20220274)
出版年
2024
NETL
NSTL
万方数据