血管内超声对冠状动脉粥样硬化斑块及其狭窄的研究  

Study on Coronary Atherosclerotic Plaque and Coronary Artery Stenosis by Intravascular Ultrasound

作　　者：马明远[1] 李榕生[1] 杨希立[1] 李健民[1] 肖长华[1] 

机构地区：[1]佛山市第一人民医院心内科,广东省528000

出　　处：《中国超声医学杂志》2001年第4期255-257,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :应用血管内超声 ( IVUS)检测冠状动脉 ,探讨其不同性质斑块的超声特征及其血管的代偿性重构能力。方法 :应用 IVUS检测 71例患者 89处冠状动脉血管段总截面的最大径和最小径、管腔最大径和最小径、总截面面积及管腔面积。算出斑块的面积狭窄率和直径狭窄率 ,然后将所测值进行统计学分析。结果 :1血管总截面积随斑块面积的增加而增加 ,少量斑块组 (面积狭窄率 <40 % )的增加比例最大 ,其斑块面积每增加 1mm2 ,血管总截面积就增加 1.99mm2 ;硬斑块组增加比例最低 ,斑块面积每增加 1mm2 ,血管总截面积才增加 0 .5 8mm2 ;大量斑块组 (面积狭窄率≥ 40 % )的斑块面积每增加 1mm2 ,血管总截面积增加 1.0 6 mm2 ;2血管腔面积与斑块面积无相关 (硬斑块组除外 ,它呈弱负相关 ) ;3血管总截面积与血管腔面积呈正相关 (硬斑块组除外 ) ;4直径狭窄率与面积狭窄率呈明显正相关。结论 :1病变血管的代偿性重构能力与斑块的狭窄程度及性质有关 ,它以轻度病变为最高 ,硬斑块为最低 ,重度病变并未完全消失 ;2病变血管腔的大小与斑块的性质关系较大 ,而与斑块的形态关系不大 ;3可用直径狭窄率代替面积狭窄率判断血管的狭窄程度 。Objective:We detected the coronary arteries by intravascular ultrasound(IVUS)and studied the different ultrasonic characteristics of plaques and the compensatory ability of remodeling.Methods:IVUS was done in 89 coronary vascular segments of 71 patients.We measured the maximal and minimal diameter of total vessel area(TVA)and lumen diameter,the TVA and lumen area(LA),and calculated the plaque area(PA)stenosis rate and diameter stenosis rate which were analysed statistically.Results:①The more PA increased,the more TVA increased.In the small plaque group(area stensis rate<40%),TVA was increased most obviously,namely,TVA was increased 1 99mm 2 per 1mm 2 increased in each PA.In hard plaque group TVA was increased least obviously,namely,TVA was increased 0 58mm 2 per 1mm 2 increased in each PA.The big plaque group(area stenosis rate≥40%),TVA was increased 1 06mm 2 per 1mm 2 in each PA.② The LA had no correlation to PA except the hard plaque group in which LA had slightly negative correlation.③TVA had correlation to LA except the hard plaque group.④The diameter stenosis rate had significant correlation to area stenosis rate.Conclusions:①The ability of compensable remodeling in lesioned vessels had correlation to the severity and characteristics of the plaque.The minor lesion remodeled most strongly,the hard plaque remodeled vessels least,and severe lesions never disappeared completely.②The diameter of the lesioned arterial lumen was more related to the characteristics of plaques and less related to the morphology.③We can use the diameter stensosis rate instead of the area stenosis rate to determine the degree of the lumen stenosis and to make the detection faster and more convenient.

关 键 词：血管内超声 冠脉斑块 血管代偿性重构 冠状动脉粥样硬化斑块 

分 类 号：R445.1[医药卫生—影像医学与核医学]