血管内超声与冠状动脉造影在不稳定性心绞痛患者冠状动脉轻度狭窄中的显像特征

目的探讨血管内超声(IVUS)与冠状动脉造影(CAG)在不稳定性心绞痛患者冠状动脉轻度狭窄中的显像特征。方法对经CAG发现冠状动脉轻度狭窄的30例不稳定性心绞痛患者42处病变进行IVUS检查,观察病变斑块性质和血管最大狭窄程度,并对CAG和IVUS两种检查结果进行比较。结果 CAG发现,偏心性狭窄26处,向心性狭窄16处,病变最窄处血管直径狭窄率为(29.06±7.20)%;IVUS发现,偏心性斑块34处,向心性斑块8处,易损斑块28处,病变最窄处血管直径狭窄率为(37.37±6.50)%,面积狭窄率为(41.51±7.50)%。IVUS所测病变最窄处血管直径狭窄率明显高于CAG(P<0.05)。结论 CAG低估血管内病变情况,IVUS可准确地判定冠状动脉的病变性质和狭窄程度,更好地指导临床确定治疗策略。

Characteristics of IVUS and CAG in the patients with unstable angina with angiographic mild coronary stenosis

Objective To investigate the characteristics of lesion of angiographic mild coronary stenosis using intravascular ultrasound(IVUS) and coronary angiography(CAG) in patients with unstable angina.Methods Forty-two coronary artery segments with mild stenosis found by CAG in 30 patients were examined by IVUS to analyze the characteristics of the plaques.The morphology and severity of stenoses measured by the two techniques were compared.Results Twenty-six eccentric stenoses and 16 concentric ones were found by CAG;34 eccentric plaques,8 concentric plaques and 28 vulnerable plaques were detected by IVUS.There was significant difference in stenosis rate of the diameters at the narrowest sites of the stenosed vessels between CAG and IVUS [(29.06±7.20)%vs(37.37±6.50)%,P<0.05].The area stenosis rate determined by IVUS was(41.51±7.50)%.Conclusion The CAG underestimates the intravascular lesion of coronary artery,while IVUS can identify it accurately.