血管内超声在冠状动脉左主干病变介入诊疗中的应用价值  

The application value of intravascular ultrasound in guiding the application of CAG in interventional diagnosis and treatment of left main coronary artery disease

作　　者：赵荣诚[1] 徐泽升[1] ZHAO Rongcheng;XU Zesheng(Heart Disease Center,Central Hospital of Cangzhou City,Hebei,Cangzhou 061001,China)

机构地区：[1]河北省沧州市中心医院心脏中心

出　　处：《河北医药》2019年第17期2602-2605,共4页Hebei Medical Journal

基　　金：沧州市科学技术研究与发展支撑计划项目(编号:1123028ZD)

摘　　要：目的探讨分析血管内超声(IVUS)对冠状动脉造影(CAG)在冠状动脉左主干病变介入诊治中应用的指导价值。方法78例冠状动脉左主干病变患者随机分为对照组与试验组,每组39例。对照组使用CAG在冠状动脉左主干病变介入诊治,试验组使用血管内超声对CAG在冠状动脉左主干病变介入诊治、比较2组患者治疗效果、支架置入效果及不良反应发生概率等,评价IVUS分析试验组患者病变血管管腔特点的临床价值。结果试验组患者左主干平均参考直径、最小管腔直径及面积大于对照组测量数值(P<0.05),对照组使用定量冠状动脉造影法(QCA法)在测量左主干远段分叉病变长度方面准确度较差;试验组指导下的支架置入后扩张比例明显高于对照组指导下的扩张比例(P<0.05);对照组患者不良反应发生率显著高于试验组(P<0.05)。与第一分位比较,患者病变血管管腔面积、管腔最大径、管腔最小径和管腔平均径的第二分位、第三分位明显升高,差异有统计学意义(P<0.05)。患者病变血管管腔偏心指数第一分位和第二分位差异无统计学意义(P>0.05)、第二分位明显高于第一分位,差异有统计学意义(P<0.05)。结论IVUS(血管内超声)对CAG在冠状动脉左主干病变介入诊治中应用的指导价值较高,能有效诊断冠心病左主干病变,并减少不良反应率。Objective To investigate the guidance significance of intravascular ultrasound(IVUS)in in guiding the application of coronary arteriongraphy(CAG)interventional diagnosis and treatment of left main coronary artery disease.Methods A total of 78 patients with left main coronary artery disease who were treated in our hospital from March 2015 to August 2016 were enrolled in the study,who were randomly divided into experimental group(n=39)and control group(n=39).The patients in control group were treated by CAG intervention therapy,however,the patients in experimental group,on the basis of control group,were treated by intravascular ultrasound.The therapeutic effects,stent implantation effects and adverse reactions were observed and compared between the two groups.Moreover the clinical value of IVUS in analysing vascular lumen characteristics was evaluated.Results The mean reference diameter,minimum lumen diameter and area of the left main trunk in experimental group were significantly larger than those in control group(P<0.05).The accuracy of QCA(quantitative coronary angiography)in measuring the length of distal bifurcation lesions of left main trunk in control group was poor.The expansion ratio after stent placement in experimental group was significantly higher than that in control group(P<0.05).The incidence of adverse reactions in control group was 74.36%(28/39),which was significantly higher than that[48.72%(19/39)]in experimental group(P<0.05).Conclusion The intravascular ultrasound has higher application value in guiding the application of CAG in interventional diagnosis and treatment of left main coronary artery disease,which can effectively diagnose left main coronary artery disease and reduce the incidence rate of adverse reactions.

关 键 词：超声 CAG 冠状动脉左主干病变 诊治 

分 类 号：R541.4[医药卫生—心血管疾病]