应用光学相干断层成像指导经皮冠状动脉介入治疗对急性冠脉综合征患者远期预后的影响  

Effect of percutaneous coronary intervention guided by optical coherence tomography on long-term prognosis of patients with acute coronary syndrome

作　　者：薛增明[1] 李雅超 赵志刚[1] 雷梦杰 安蕾 杨彦立[1] 王敬尧 周海立[1] XUE Zeng-ming;LI Ya-chao;ZHAO Zhi-gang(Department of Cardiology,Langfang People's Hospital,Langfang Hebei 065000,China.)

机构地区：[1]廊坊市人民医院心内科,河北廊坊065000

出　　处：《临床和实验医学杂志》2022年第12期1325-1328,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省省级科技计划自筹经费项目(编号:182777166)。

摘　　要：目的探讨光学相干断层成像(OCT)指导经皮冠状动脉介入(PCI)治疗对急性冠脉综合征(ACS)患者远期预后的影响。方法回顾性分析2018年1月至2020年12月在廊坊市人民医院行PCI治疗的948例非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者,根据疾病类型不同分为两组,非ST段抬高型心肌梗死(NSTEMI)组(n=790)和不稳定型心绞痛(UAP)组(n=158);组内再根据PCI治疗指导方式不同分为冠状动脉造影(CAG)组(n=822)和OCT组(n=126)。对比NSTEMI组与UAP组病变特征,同时比较CAG组和OCT组一般资料、支架置入情况、术后1年主要心脏不良事件(MACE)发生率。结果NSTEMI组病变狭窄程度高于UAP组,易损斑块多于UAP组,差异均有统计学意义(P<0.05)。CAG组与OCT组一般资料比较,差异无统计学意义(P>0.05)。CAG组支架小梁内膜覆盖率、最小支架面积分别为(88.45±6.51)%、(4.23±1.12)m^(2),明显低于OCT组[(92.74±7.18)%、(4.62±1.05)m^(2)],差异均有统计学意义(P<0.05),支架贴壁不良及支架边缘夹层发生率与OCT组比较差异无统计学意义(P>0.05)。术后1年,CAG组与OCT组MACE发生率比较,差异无统计学意义(P>0.05)。结论与CAG相比,OCT指导NSTE-ACS介入治疗可以提高支架置入成功率,但无法改善患者远期预后。Objective To investigate the effect of optical coherence tomography(OCT)guided percutaneous coronary intervention(PCI)on long-term prognosis of patients with acute coronary syndrome(ACS).Methods 948 patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)treated with PCI in Lang Fang People's Hospital from January 2018 to December 2020 were retrospectively analyzed and divided into two groups according to different disease types.Non-ST-segment elevation myocardial infarction(NSTEMI)group(n=790)and unstable angina pectoris(UAP)group(n=158);the patients in the group were further divided into coronary angiography(CAG)group(n=822)and OCT group(n=126)according to different PCI treatment guidance methods.The characteristics of NSTEMI group and UAP group were compared,and the general data,stent implantation and incidence of major adverse cardiac events(MACE)1 year after operation were compared between CAG group and OCT group.The characteristics of NSTEMI group and UAP group were compared,and the general data,stent implantation and incidence of major adverse cardiac events(MACE)1 year after operation were compared between CAG group and OCT group.Results The stenosis degree of NSTEMI group was higher than that of UAP group,and the vulnerable plaque was more than that of UAP group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the general data between the CAG group and the OCT group(P>0.05).The stent coverage rate and minimum stent area in CAG group were(88.45±6.51)%,(4.23±1.12)m 2 respettively,which were significantly lower than those in OCT group[(92.74±7.18)%,(4.62±1.05)m 2],the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of poor adhesion and edge dissection between the two group(P>0.05).One year after operation,there was no statistically significant difference in the incidence of MACE between CAG group and OCT group(P>0.05).Conclusion Compared with CAG,OCT guided NST

关 键 词：急性冠脉综合征 经皮冠状动脉介入 冠状动脉造影 光学相干断层成像 主要心脏不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]