血管内超声指导介入治疗左前降支病变疗效  

Percutaneous coronary intervention to left anterior descending guided by intravascular ultrasound

作　　者：王斌[1] 韩雅玲[1] 荆全民[1] 王效增[1] 马颖艳[1] 梁振洋[1] 王耿[1] 徐凯[1] 刘海伟[1] 关绍义[1] 方毅[1] WANG Bin HAN Ya-ling JING Quan-min WANG Xiao-zeng MA Ying-yan LIANG Zhen-yang WANG Geng XU Kai LIU Hai-wei GUAN Shao-yi FANG Yi(Department of Cardiology, The General Hospital of Shenyang Military Command, Shenyang 110016, China)

机构地区：[1]沈阳军区总医院心血管内科,辽宁沈阳110016

出　　处：《临床军医杂志》2016年第11期1101-1103,共3页Clinical Journal of Medical Officers

基　　金：军队临床高新技术重大项目(2010gxjs001);辽宁省科技攻关项目(2013225089)

摘　　要：目的探讨血管内超声(IVUS)指导下介入治疗左前降支(LAD)病变的疗效。方法选取2015年11月至2016年7月收治的LAD近段或中段接受经皮冠状动脉介入(PCI)治疗的冠心病患者28例。比较冠状动脉造影指导下判定的拟置入支架的参数与IVUS指导下判定的拟置入支架的参数。以IVUS获得的参数作为最终置入支架参数。结果造影指导下预判支架长度为(30.5±11.6)mm,IVUS指导下预判支架长度为(29.2±11.4)mm,两者比较,差异无统计学意义(P>0.05)。造影指导下预判支架直径为(2.93±0.36)mm,IVUS指导下预判支架直径为(3.14±0.39)mm,两者比较,差异有统计学意义(P<0.05)。除2例造影和IVUS提示血管相对正常节段不同的患者,造影指导下预判支架长度为(29.5±11.2)mm,IVUS指导下预判支架长度为(29.3±11.5)mm,两者比较,差异无统计学意义(P>0.05);造影指导下预判支架直径为(2.91±0.35)mm,IVUS指导下预判支架直径为(3.13±0.40)mm,两者比较,差异有统计学意义(P<0.05)。结论应用IVUS指导行LAD介入治疗,获得的支架直径大于应用造影指导获得的支架直径。获得支架长度两种方法无差异。少数情况下,应用IVUS发现的血管相对正常节段与冠状动脉造影不同。Objective To explore the efficacy of percutaneous coronary intervention（ PCI） to left anterior descending artery（ LAD）guided by intravascular ultrasound（ IVUS）. Methods A total of 28 patients with coronary heart disease admitted from November 2015 to July 2016 were enrolled. PCI was done to LAD guided by IVUS. The parameters about the length and the diameter of stents were determined by angiography and IVUS respectively and were compared. The parameters from IVUS were the parameters of implanted stents. Results The stent length from angiography was（ 30. 5 ± 11. 6） mm,which had no difference compared with the stent length from IVUS（ 29. 2 ± 11. 4） mm（ P 0. 05）. The stent diameter from IVUS was（ 3. 14 ± 0. 39） mm,which was different with it from angiography（ 2. 93 ± 0. 36） mm（ P 0. 05）. After two patients whose relatively normal vessel segment was different from angiography and IVUS were excluded,the stent length from angiography was（ 29. 5 ± 11. 2） mm,which had no difference with the stent length from IVUS（ 29. 3 ± 11. 5） mm（ P 0. 05）. The stent diameter from IVUS was（ 3. 13 ± 0. 40） mm,which was different with it from angiography（ 2. 91 ± 0. 35） mm（ P 0. 05）. Conclusion To perform LAD interventional therapy guided by IVUS,the stent diameter is greater than the application of imaging guidance. There is no statistical significant to get the stent length. The relatively normal vessel segment is different from angiography and IVUS in some rare settings in few cases.

关 键 词：血管内超声 左前降支 血管成形术 经腔 经皮冠状动脉 

分 类 号：R541.4[医药卫生—心血管疾病] R543[医药卫生—内科学]