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摘要: 慢性完全闭塞病变(CTO)被称作是冠状动脉经皮介入治疗的最后一座堡垒，基于CTO病变病理成分相关研究而开发的血管内药物辅助介入治疗可软化CTO病变成分，易化导丝通过，目前Ⅱ期临床试验已经完成，有望为CTO病变再通提供新途径。本文就胶原酶辅助介入治疗研究进展进行综述。
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关键词:
- 冠心病 /
- 经皮冠状动脉介入治疗 /
- 慢性完全闭塞病变 /
- 基质金属蛋白酶
Abstract: Chronic total occlusion(CTO) remains one of the major challenging obstacles in coronary intervention. Collagenase-assisted interventional therapy based on the study of pathological components of CTO lesions can soften the components of CTO lesions and make the wire across the lesions easier. Phase Ⅱ clinical trials have been completed, which is expected to provide a new way for the recanalization of CTO lesions. This article will review the progress in collagenase-assisted interventional therapy. -
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表 1 胶原酶相关临床研究
Table 1. Characteristics of clinical study on collagenase
项目 入选人群 有效性终点 安全性终点 围术期 术后 Ⅰ期临床研究 既往导丝通过失败的CTO患者(20例) 导丝通过率：80%(16例) 心肌梗死：3例患者因侧支缺血发生非ST段抬高型心肌梗死。 术后3个月的CTA显示，在成功开通的CTO患者中，支架通畅且没有迟发并发症。 Ⅱ期临床研究 既往导丝通过失败的CTO患者(75例) PCI手术成功率：组间无显著差异。软导丝通过率：对照组小于两胶原酶组(P=0.03) 围术期心肌坏死：对照组出现2例，900 μg剂量组2例，1200 μg剂量组4例。全部与侧支闭塞或穿孔相关。 术后30 d内对照组出现1例心肌梗死，而胶原酶组未出现相关并发症。 
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| 引用本文: |
申学谦, 史雨晨, 见闻, 等. 冠状动脉慢性完全闭塞中胶原酶辅助介入治疗研究进展[J]. 临床心血管病杂志, 2022, 38(12): 951-954. doi: 10.13201/j.issn.1001-1439.2022.12.005
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| Citation: |
SHEN Xueqian, SHI Yuchen, JIAN Wen, et al. Collagenase-assisted interventional therapies for chronic total coronary occlusion[J]. J Clin Cardiol, 2022, 38(12): 951-954. doi: 10.13201/j.issn.1001-1439.2022.12.005
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