赵旭　　任昊　　王刃

[關键词] 药物涂层球囊;经皮腔内血管成形术;下肢动脉硬化闭塞症;踝肱指数;再狭窄率

[中图分类号] R654.3          [文献标识码] B          [文章编号] 1673-9701（2021）14-0066-04

Clinical effect observation of percutaneous transluminal angioplasty with drug-coated balloon in the treatment of arteriosclerosis obliterans of lower extremities

ZHAO Xu   REN Hao  WANG Ren

Department of Vascular Surgery， Dalian Municipal Central Hospital， Dalian   116021， China

[Abstract] Objective To explore the value of percutaneous transluminal angioplasty （PTA） with drug-coated balloon （DCB） for patients with arteriosclerosis obliterans of lower limbs. Methods A total of 50 patients with arteriosclerosis obliterans of lower limbs admitted in our hospital from February 2018 to February 2020 were enrolled in this study. Those patients were divided into groups by random number table， in which 25 patients were treated with PTA with ordinary balloon （study group 1） and the other 25 patients were treated with PTA with drug-coated balloon （study group 2）. The ankle-brachial index（ABI）， minimum lumen diameter（MLD） of lower limb artery， stenosis degree of lower limb artery and late lumen loss（LLL） were evaluated in both groups. The proportion of Rutherford grade > grade 3 and ≤ grade 3， the incidence of target lesion revascularization （TLR）， restenosis rate， amputation rate and the incidence of adverse events were counted. Results Three months after operation， ABI， MLD of lower limb artery， stenosis degree of lower limb artery and LLL value in the study group 2 were （0.78±0.19）， （3.57±0.56） mm， （24.82±7.19）% and （0.45±0.09）mm， respectively， which were better than those in study group 1 [（0.53±0.15）， （2.01±0.35） mm， （58.26±6.18）% and （1.67±0.24）mm] （P<0.05）. The proportion of people with Rutherford classification>grade 3 in the study group 2 was 24.00%， which was significantly lower than that in study group 1（60.00%， P<0.05）. The restenosis rate， TLR rate and amputation rate in the study group 2 were 12.00%， 8.00% and 4.00%， respectively， which were lower than those in the study group 1 （68.00%， 56.00% and 12.00%， P<0.05）. Conclusion The rational application of DCB in PTA for patients with arteriosclerosis obliterans of lower limbs can significantly improve ABI value and arterial stenosis， promote the recovery of arterial blood flow of patients′ lower limbs， and effectively avoid restenosis and amputation.

[Key words] Drug-coated balloon; Percutaneous transluminal angioplasty; Arteriosclerosis obliterans of lower limbs; Ankle brachial index; Restenosis rate

下肢动脉硬化闭塞症主要指机体下肢发生动脉粥样硬化，形成斑块造成下肢动脉出现狭窄甚至闭塞的情况，使得肢体呈慢性缺血状态[1-2]。临床多采用经皮腔内血管成形术（Percutaneous tranluminal angioplasty，PTA）开展治疗，但是临床长期应用后也发现该术式存在一定弊端，例如术后再发生狭窄的可能性较高。研究发现，针对PTA术式采用药物涂层球囊（Drug coated balloon，DCB）能够促使病变段再通畅率有效提高[3]。谈洪统等[4]报告中也指出，药物涂层球囊PTA治疗下肢动脉硬化闭塞症安全、有效，可以降低再狭窄率，且近期疗效优于普通球囊。故本研究将使用DCB开展PTA术式实施于我院下肢动脉硬化闭塞症患者治疗中，并与普通球囊作对比，深入探讨其应用价值，现报道如下。

1 资料与方法

1.1 一般资料

选取我院2018年2月至2020年2月收治的50例下肢动脉硬化闭塞症患者作为观察对象，依据随机数字表法分成两组，每组各25例。A组男女比例15∶10，年龄49～76岁，平均（62.47±4.59）岁;B组男女比例14：11，年龄50～75岁，平均（62.51±4.63）岁。两组年龄、性别比较，差异无统计学意义（P>0.05），具有可比性。

纳入标准[5]：①均符合下肢动脉硬化闭塞症临床诊断标准;②均符合经皮腔内血管成形术手术指征（即下肢动脉狭窄程度达到并超过70%或者闭塞，病变长度在20 cm以下）;③Rutherford分级在2～5级;④均知晓认可本次研究并签署《知情同意书》;⑤本次试验经过医院医学伦理委员会批准。

排除标准……