冠状动脉夹层的血管内超声分类及其临床意义  

Coronary dissection assessed by intravascular ultrasound: its classification and clinical significance

作　　者：马依彤[1,2] 汪师贞[1,2] 森内正人 小泽友纪雄 

机构地区：[1]新疆医学院第一附属医院心内科 [2]日本大学医学部第二内科

出　　处：《中华心血管病杂志》1997年第2期98-102,共5页Chinese Journal of Cardiology

摘　　要：本研究目的是采用血管内超声检查方法对在介入性导管治疗后冠状动脉夹层的形态特征做出评价和分类。在１１３例患者中，发现３５例（３１％）有夹层存在。同时可观察到有四种夹层类型包括边缘型（Ⅰ型）１８例（５１％）；中心型（Ⅱ型）９例（２６％）；无通道型（Ⅲ型）２例（６％）和假腔型（Ⅳ型）６例（１７％）。所有Ⅰ～Ⅲ型的病人，均获得了临床治疗的成功。而Ⅳ型病人均发生了急性冠状动脉闭塞。冠状动脉夹层的发生与斑块偏心性（Ｐ＜０．０１）和浅在性钙化斑块（Ｐ＜０．０１）显著相关。我们提出冠状动脉夹层在血管内超声上的形态学分类，并认为成功的冠状动脉扩张治疗后常常伴有动脉夹层形成，而少数夹层则与急性闭塞的产生有关。To investigate and classify the coronary dissection after catheter angiopalsty by intravascular ultrasound, 113 patients were examined. Morphologic evidences of dissection were identified in 35 patients (35/113, 31%). Four distinct morphologic patterns of the dissection were observed. Borderline type (type Ⅰ) was found in 18 patients (18/35, 51%), central type (type Ⅱ) in 9 patients (9/35, 26%), no entry type in 2 patients (2/35, 6%) and pseudolumed dilatation type (type Ⅳ) in 6 patients (17/35, 17%). The clinical success was found in all but type Ⅳ patients. All type Ⅳ patients had acute coronary closure. The occurrence of coronary dissection was significantly correlated with plaque eccentricity ( P <0.01) and the existence of superficial calcification of plaque ( P <0.01). It is concluded that coronary dissection often occurs after coronary angioplasty and acute closure is related to the type of dissection.

关 键 词：主动脉瘤 超声波诊断 

分 类 号：R543.160.4[医药卫生—心血管疾病]