血管内超声在指导冠状动脉临界病变治疗方案选择的意义

目的：探讨血管内超声在指导冠状动脉临界病变治疗方案选择的意义。方法选择冠状动脉造影显示单支血管临界狭窄患者63例为研究对象。纳入研究的患者均行血管内超声检查，以最小管腔面积≤4mm2或者面积狭窄≥60%为标准采用冠脉内支架置入术治疗，达不到以上标准者采用药物治疗。随访患者不良心脏事件、硝酸酯类药物治疗情况。结果血管内超声检测结果显示，介入治疗的患者以软斑块为主，正性重构的比例较高，面积狭窄程度＞保守治疗的患者，最小管腔面积＜保守治疗的患者，重构指数大，两组患者比较，差异有统计学意义（P＜0.05）。两组随访期间均没有急性心肌梗死、心源性猝死的病例，随访结果比较差异无统计学意义（P＞0.05）。结论血管内超声能够明确冠脉临界病变的性质和程度，对指导治疗方案的选择具有临床意义。

The meaning of intravascular ultrasound in the guidance of critical coronary artery lesions treatment options

Objective To discuss the meaning of intravascular ultrasound in the guidance of critical coronary artery lesions treatment options. Methods 63 cases with critical stenosis in patients with single blood vessels by coronary arteriography were selected as subjects.All patients were detected by intravascular ultrasound,and minimum lumen area≤4mm2 or plaque burden≥60%for the standard to use of intravascular carotid stenting treatment,and patients without meet the above criteria to use of drug treatment.Major adverse cardiac events,receiving nitrates treatment were followed up. Results Intravascular ultrasound showed interventional treatment of patients were priority to with soft plaque,the proportion of positive refactoring was higher,area of narrow degree were lager than conservative treatment of patients,minimum lumen area was smaller than onservative treatment of patients, refactoring index waslarger,and there were significant differences between two groups（P 〈 0.05）.In follow-up period,no acute myocardial infarction and sudden cardiac death occurred,and follow-up results of two groups showed no significant difference（P 〉 0.05）. Conclusion Intravascular ultrasound can determine the nature and degree of coronary borderline lesions,and shows clinical significance to guide the choice of treatment.