冠状动脉临界病变斑块在血管内超声检测中的价值  

Diagnostic value of IVUS for borderline lesion and relation of high sensitive C-reactive protein with plaque

作　　者：周昭仑[1] 杨希立[1] 许兆延[1] 李健民[1] 肖长华[1] 李洁源[1] 

机构地区：[1]广东省佛山市第一人民医院心血管内科,528000

出　　处：《中国医药》2008年第7期407-409,共3页China Medicine

摘　　要：目的探讨血管内超声（IVUS）检测在冠状动脉造影显示冠状动脉临界病变中的应用价值。方法冠状动脉造影显示临界病变患者99例，应用IVUS检测108处病变血管外弹力膜截面积（EEMCSA）、最小管腔截面积（MLA）、面积狭窄百分比（％AS）、参照管腔直径（RLD）、血管直径（VD）、最小管腔直径（MLD）、直径狭窄百分比（％DS）。依据IVUS检测结果分成介入组和非介入组。介入组41例43处病变、非介入组58例65处病变。结果冠状动脉造影显示的MLD、％DS和％AS均低于IVUS的检测值（P〈0．05）。介入组平均面积狭窄率为75．3％，符合介入指征，与非介入组的42.6％比较，2组差异有统计学意义（P〈0.05）。置入支架前后除EEM—CSA，VD无明显变化，MLA、％AS、MLD及％DS指标差异均有统计学意义（P〈0．05）。结论IVUS对临界病变斑块性质、诊断及治疗决策有很好的指导作用。Objective To investigate the diagnostic value of intravascular ultrasound （IVUS） to borderline lesion presented in coronary angiography （CAG）. Methods A total of 99 borderline cases were confirmed by CAG, among of which external elastic membrane cross-sectional area （EEM-CSA） , minimal lumen area （MLA） , area stenosis（%AS） , referece lumen diameter（RLD）, vessel diameter（VD） , minimal lunmen diameter （MLD） ,and diameter stenosis（% DS ）were measured by IVUS in 108 lesion. According to the results of IVUS, patients were divided into interventional group （41 cases with 43 lesions） and non -interventional group （58 cases with 65 lesions）. In the interventional group, all the indexes above were rechecked by IVUS post PCI. Results MLD, % DS and % AS presented by CAG were significantly lower than those by IVUS （ P 〈 0.05 ） , which could clearly demonstrate the characters of plaque and the severity of stenosis. Average of % AS in the interventional and non-interventional group was significantly different （ 75.3% vs. 42.6% , P 〈 0.05）. Except EEM-CSA and VD, MLA, % AS, MLD and % DS were all significantly different in pre-and post-PCI （ P 〈 0.05 ）. Conclusion IVUS has favorable effects in diagnosis and therapeutic strategy to borderline lesions.

关 键 词：冠状动脉粥样硬化性心脏病 冠状动脉造影 血管内超声 

分 类 号：R541.4[医药卫生—心血管疾病]