血管内超声在介入治疗冠状动脉临界病变中的价值

目的评价血管内超声（IVUS）在冠状动脉临界病变中的应用价值。方法对冠状动脉造影（CAG）提示单支冠状动脉临界病变的54例患者进行IVUS检查,根据IVUS面积狭窄率≥50%分为介入干预组及对照组。观察斑块的性状及IVUS面积狭窄率,并进行随访观察并发症。结果介入干预组32例,对照组22例,介入干预组斑块性状以软斑块及偏心性斑块为主,介入治疗中无明显的并发症,随访1年,介入治疗组再发心绞痛3例,对照组发生心绞痛4例,心梗2例,猝死1例,2组比较差异有统计学意义（P〈0.05）。结论IVUS对临界病变的狭窄程度及指导介入治疗有一定的价值,对IVUS面积狭窄率≥50%的病变进行介入干预预后良好。

The clinical application value of intravascular ultrasound in the examination for patients with intermediate coronary stenosis

Objective To evaluate the clinical application value of intravascular ultrasound（IVUS） in the examination for patients with angiographical-intermediate coronary stenosis. Methods Fifty-four patients with single vessel intermediate stenosis identified by quantitative coronary angiography were examined by IVUS to evaluate the plaque characteristics and the severity of the area stenosis. According to the severity of the area stenosis （IVUS≥50%） ,the patients were divided into percutaneous coronary intervention （PCI） group （ n = 32） and non-PCl group （ n = 22）. Results The more soft and eccentric plaques were found in PCI group,after l year follow up,cardiac events （angina pectoris）occurred in 3 cases （9.4%） in PCI group,however,which occurred in 7 patients （31.8%） including 4 cases of angina pectoris,2 eases of myocardial infarction and 1 case of sudden death in non-PCl group. There was a significant difference in the occurrence rate of cardiac events between PCI group and non-PCl group （9.4% vs 31.8% , P 〈 0.05）. Conclusion IVUS can quantify precisely the extent of lesions in patients with intermediate stenosis by angiography and guide coronary interventions. The PCI in culprit coronary artery with the area stonosis identified by IVUS≥50% has a good prognosis.