摘要
目的探讨对比TAP(T and small Protrusion)技术与单支架技术治疗冠状动脉分叉病变的短期疗效。方法根据冠状动脉造影结果将冠心病分叉病变患者随机分为TAP组及单支架组,所有患者主支血管直径均≥2.5 mm,分支血管直径≥2.0 mm。TAP组采取边支球囊扩张后植入支架(TAP技术),单支架组边支球囊扩张,不植入支架。检测手术局部麻醉后、术后1、24和72 h C-反应蛋白(CRP)及脑钠肽(BNP)的水平,并记录心绞痛、心肌梗死等主要心脏不良事件(MACE)的发生情况。结果所有患者均完成手术。两组的短期疗效比较,TAP组的心绞痛及MACE发生率明显减少(P<0.05);TAP术后24、72 h的CRP及BNP组明显低于单支架组(P<0.05)。结论 TAP技术治疗冠状动脉分叉病变的短期疗效优于单支架技术,且手术安全性高。
Objective To compare the short- term clinical effectiveness of T stenting and small protrusion （TAP） technique with simple stenting technique in treating coronary artery bifurcation lesions. Methods Based on the coronary angiography findings, the patients with coronary artery bifurcation lesions were randomly divided into TAP group （n = 75） and simple stenting group （n = 63）. In all patients, the diameter of the main vessel （MV） was≥ 2.5 mm the diameter of side branch （SB） was ≥ 2.0 mm. In TAP group, the stent implantation of MV was accomplished first. Then, the guide-wire was inserted into the side branch through MV stent mesh and the balloon dilatation of the side branch was carried out which was followed by the implantation of provisional drug-eluting stent in the dilated side branch with the provisional stent being a little bit （1 - 2 mm） protruded into the＇MV stent. In simple stenting group only balloon dilatation of the side branch was employed. The concentrations of serum C-reactive protein （CRP） and brain natriuretic peptide （BNP） were determined immediately after local anaesthesia performance, as well as at one, 24 and 72 hours after the operation. The occurrences of major adverse cardiac events （MACEs） such as angina, cardiac infarction, etc. were recorded. The results were analyzed and compared between the two groups. Results The interventional procedure was successfully accomplished in all patients. The short-term effectiveness of TAP group was much better than that of simple stenting group, and the difference between the two groups was significant. The incidence of angina and other MACEs in TAP group was significantly lowerthan that in simple stenting group （P 〈 0.05）. In TAP group the concentrations of serum CRP and BNP determined at 24 and 72 hours after the operation were markedly lower than those in simple stenting group （P 〈 0.05）. Conclusion In treating coronary bifurcation lesions, the short-termeffectiveness and safety of T stenting and small protrusion technique is superior to those of simple stenting technique.
出处
《介入放射学杂志》
CSCD
北大核心
2013年第4期279-282,共4页
Journal of Interventional Radiology
基金
广西区卫生厅自筹课题Z2007295
关键词
冠状动脉分叉病变
TAP技术
C-反应蛋白
脑钠肽
心脏不良事件
T and small protrusion technique
coronary artery bifurcation lesion
C-reactive protein
brain natriuretic peptide
major adverse cardiac event
