血管内超声指导冠脉临界病变介入治疗的应用价值

目的：探讨血管内超声（IVUS）检查在冠状动脉临界病变介入治疗中的应用价值。方法：选择我院130例经冠状动脉造影（CAG）证实为临界病变的患者进行前瞻性研究，随机分为CAG组（95例，接受CAG检查）和IVUS组（35例，先后接受CAG和IVUS检查）。应用量化冠状动脉造影（QCA）分析法和血管内超声定量分析法测量两组最小管腔直径、参考血管直径、直径狭窄率及面积狭窄率的差异，并比较住院期间及随访期间的主要心血管事件（MACE）的发生情况。结果：与CAG组相比，IVUS组的冠脉内膜钙化率8．4％（8／95）比28．6％（10／35）]，直径狭窄率（43．97±6．53）%比（55．25±7．41）％]及面积狭窄率（56．48±10．38）％比（69．87±9．97）％]显著升高（P〈0．05），而最小管腔直径及参考血管直径无显著差异（P〉0．05）。住院期间两组的MACE发生率无差异（P〉0．05），但自随访1月起IVUS组的MACE发生率显著低于CAG组（2．86％比6．32％，P〈0．05）。结论：血管内超声检查能显著提高冠脉临界病变的检出率，更好地指导冠脉介入治疗，防止并发症，改善预后．

Clinical value of intravascular ultrasound imaging on guidance of interventional treatment for interme-diate coronary lesions

Objective： To analyze application value of intravascular ultrasound imaging （IVUS） on guidance of inter-ventional treatment for intermediate coronary lesions. Methods： A total of 130 patients were proved to be intermedi-ate lesions by coronary angiography （CAG） from our hospital were prospectively studied, and they were randomly divided into CAG group （n = 95, received CAG examination） and IVUS group （n = 35, received IVUS after CAG）. Quantifying coronary angiography （QCA） and IVUS quantitative analyses were used to measure difference in mini- mal lumen diameter, reference vessel diameter, stenotic rates of diameter and area between two groups, and inci-dence rate of major adverse cardiovascular events （MACE） during admission and follow-up were compared between two groups. Results： Compared with CAG group, there were significant increase in coronary intimal caleification E8. 4% （8/95） vs. 28.6% （10/35） ], stenotic rates of diameter （43.97 ± 6.53） % vs. （55.25 ± 7.41） %] and area F （56.48 ± 10.38） % vs. （69.87 ± 9.97） %] in IVUS group （ P〈0.05 both）, but there were no significant difference in minimal lumen diameter and reference vessel diameter between two groups （P〉0.05）. There was no significant difference in incidence rate of MACE during admission between two groups （P 〉 0.05）, but that of IVUS group （2.86%） was significantly lower than that of CAG group （6.32%） since one month after follow-up started （P〈0.05）. Conclusion： Intravascular ultrasound imaging can significantly increase detection rate of intermediate coro-nary lesion, better guide percutaneous coronary intervention, prevent complications and improve prognosis.