血管内超声对冠状动脉临界病变的临床应用

目的应用血管内超声(IVUS)对冠状动脉造影(CAG)提示冠状动脉临界病变的患者检查,评价IVUS在冠状动脉临界病变诊断及治疗中的应用价值。方法选择经CAG诊断为冠状动脉存在临界狭窄的78例患者,其中男性56例,女性22例;年龄34～71岁,平均年龄55.4岁。行IVUS检查和CAG,对照分析两种检查结果。结果CAG检测发现偏心性斑块31处,向心性斑块82处;而行IVUS检测发现偏心性斑块56处,向心性斑块57处。IVUS清楚显示软斑块54处,硬斑块23处,混合性斑块36例,其中探查血栓1处,溃疡2处;而CAG不能显示管腔形态及斑块特点。病变最窄处血管面积狭窄率IVUS所测值明显高于CAG,分别为68%±21%、58%±19%(P<0.05),两者比较差异具有统计学意义。结论对于CAG显示的临界狭窄病变,IVUS能更准确地判定管腔形态、病变性质及狭窄程度,对冠心病特别是有冠心病症状的患者的诊断及临床介入治疗有重要意义.

Clinical application of intravascular ultrasound in coronary artery borderline lesion

Objective To assess the value of intravascular ultrasound(IVUS) in identifying coronary artery narrowing in angiographically mildly diseased coronary arteries.Methods A total of 78 patients with angiographic mildly coronary stenosis by coronary angiography(CAG) were enrolled,male 56,female 22,aged 34-71 years old,mean age 55.4 years old.The IVUS and CAG were performed,the characteristics of atherosclerosis plaques were analyzed and stenosis rate was calculated.Results Eccentric stenosis in 31 arteries,concentric stenosis in 82 were found by CAG,56 eccentric plaques and 57 concentric plaques were demonstrated by IVUS.The IVUS clearly showed 54 of soft plaques,23 of hard plaques and 36 of mixed plaques,which had 1 exploration thrombosis and 2 of ulcers.The lumen morphology and plaque characteristics were not found by CAG,and the area stenosis rate of injured vessels of IVUS were significant higher than those of CAG(68 ± 21) % vs(58 ± 19) %,(P ﹤ 0.05)].Conclusion It is demonstrated that IVUS could accurately identify the lumen morphology,the plaque characteristics and the stenostic severity of angiographically mildly diseased coronary arteries.IVUS has important clinical value in the early diagnosis and intervention of CAD and suspected CAD.