本文選題：支架內(nèi)再狹窄 + 紫杉醇藥物球囊��； 參考：《重慶醫(yī)科大學(xué)》2015年碩士論文

【摘要】：背景隨著冠心病治療逐漸發(fā)展,介入手術(shù)植入支架的治療已成為了一種重要的方式。金屬裸支架、藥物洗脫支架雖然改善了冠心病的治療效果和預(yù)后,也帶來了新的問題——支架內(nèi)再狹窄。藥物球囊的出現(xiàn)為解決支架再狹窄帶來了希望。與傳統(tǒng)的球囊相比,藥物洗脫球囊將藥物有效持續(xù)地擴(kuò)散入血管壁,減少支架內(nèi)再狹窄的發(fā)生。紫杉醇是其中一種能有效抑制新生內(nèi)膜增殖的優(yōu)勢藥物,因此紫杉醇藥物涂層球囊在治療支架內(nèi)再狹窄有較大的潛力。目的系統(tǒng)評價紫杉醇藥物洗脫球囊(PEB)在臨床冠脈支架內(nèi)再狹窄治療中的有效性。方法計算機(jī)檢索PubMed、CNKI、Embase、Cochrone(1990年-2014年)數(shù)據(jù)庫,同時輔以其他的檢索,輸入關(guān)鍵詞,搜索所有關(guān)于紫杉醇藥物洗脫球囊在支架內(nèi)再狹窄治療中應(yīng)用的隨機(jī)對照試驗(yàn)(RCT),采用統(tǒng)一的納入標(biāo)準(zhǔn)后提取數(shù)據(jù),用RevMan 5.0進(jìn)行數(shù)據(jù)分析研究。結(jié)果最終入組了6項(xiàng)臨床研究,共801名受試者,Meta分析結(jié)果顯示：紫杉醇藥物洗脫球囊與普通球囊(CB)治療支架內(nèi)再狹窄,隨訪6個月后比較,紫杉醇球囊在以下方面均優(yōu)于普通球囊：最小管腔直徑(OR=0.54；95%CI,0.45-0.64；P0.01),晚期管腔丟失(OR=-0.48；95%CI,-0.60‖-0.36；P0.01),再狹窄率(OR=0.13；95%CI,0.25-0.40；P0.01),靶血管血運(yùn)重建率(OR=0.15；95%CI,0.06-0.36； P0.01),總死亡率(OR=0.34；95%CI,0.13～0.89,P=0.03),主要心血管事件(MACE)發(fā)生率(OR=0.14；95%CI,0.08～0.23,P0.01)。結(jié)論本研究結(jié)果顯示,紫杉醇藥物洗脫球囊與普通球囊相比,治療支架內(nèi)再狹窄的療效更好,并可改善預(yù)后,作為一種新的冠脈介入治療選擇,紫杉醇藥物洗脫球囊顯出了潛在的優(yōu)勢。
[Abstract]:Background with the development of coronary heart disease treatment, interventional stent implantation has become an important way. Metallic bare stents and drug-eluting stents not only improve the therapeutic effect and prognosis of coronary heart disease, but also bring new problems-stent restenosis. The appearance of drug balloon offers hope for resolving stent restenosis. Compared with the traditional balloon, the drug elution balloon effectively diffuses the drug into the vascular wall and reduces the incidence of restenosis in the stent. Paclitaxel is one of the dominant drugs which can effectively inhibit the proliferation of neointima, so paclitaxel drug-coated balloon has great potential in the treatment of stent restenosis. Objective to evaluate the efficacy of paclitaxel-eluting balloon in the treatment of intracoronary stent restenosis. Methods the database of CNKIbase Cochrone (1990-2014) was searched by computer, supplemented by other searches, and the key words were entered. To search for all randomized controlled trials about paclitaxel elution balloon in stent restenosis treatment, the data were extracted by unified inclusion standard and analyzed with RevMan 5.0. Results A total of 801 subjects were enrolled in 6 clinical studies. The results of Meta-analysis showed that paclitaxel drug-eluting balloon and conventional balloon CB) were used to treat stent restenosis and were compared after 6 months follow-up. 绱潐閱囩悆鍥婂湪浠ヤ笅鏂歸潰鍧囦紭浜庢櫘閫氱悆鍥，

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