冠状动脉支架内再狭窄的影像诊断与治疗研究进展  

Progress in imaging diagnosis and treatment of coronary in-stent restenosis

作　　者：陈猛[1] 孟润祺 曹勇[1] 张金国[1] Chen Meng;Meng Runqi;Cao Yong;Zhang Jinguo(Department of Cardiology,Affiliated Hospital of Jining Medical University,Jining 272029,China;College of Clinical Medicine,Jining Medical University,Jining 272013,China)

机构地区：[1]济宁医学院附属医院心内科,272029 [2]济宁医学院临床医学院,272013

出　　处：《中华诊断学电子杂志》2023年第1期12-16,共5页Chinese Journal of Diagnostics(Electronic Edition)

基　　金：山东省自然基金(ZR202112020064);山东省中医药科技发展计划(2019-0481)。

摘　　要：冠状动脉支架植入术是治疗冠心病的有效手段,但支架内再狭窄(ISR)的发生在一定程度上降低甚至限制了预期的临床获益。目前,ISR的影响因素涉及范围广泛,且机制尚未明确,主要与内皮细胞和平滑肌细胞的过度增生有关。冠状动脉造影(CAG)是判断冠状动脉ISR的金标准,但二维管腔影像不能反映血管壁情况,无法准确地评估血管大小、斑块特点和支架植入效果。腔内影像学技术可以帮助识别斑块性质,早期发现薄纤维帽粥样硬化斑块等易损斑块,为临床提供更精准的血管病变信息,从而优化和指导ISR的介入治疗。因此,如何准确地评估ISR,选择有效的治疗方法意义重大。笔者就ISR的影像诊断及治疗最新进展做一综述。Although coronary stent implantation is a successful procedure for treating coronary heart disease,in-stent restenosis(ISR)can sometimes limit or even eliminate the anticipated clinical benefits.At present,the influence factors of ISR involve a wide range,and the mechanism of ISR was not clear,which was mainly related to the hyperplasia of endothelial cells and smooth muscle cells.The gold standard for diagnosing restenosis in coronary stents is coronary angiography(CAG).However,two-dimensional lumen imaging is incapable of depicting the condition of the vessel wall and assessing the vessel′s size,the characteristics of the plaque,and the impact of the stent′s implantation.Endovascular imaging technology can help the clinical provider optimize and directing the interventional treatment of ISR by assisting in the identification of plaque properties,early detection of vulnerable plaques like thin fibrous cap atherosclerotic plaque,and provision of more accurate vascular lesion information.Therefore,the only way to choose a successful treatment is to use the appropriate technology to precisely determine ISR.The most recent developments in imaging diagnostics and ISR treatment are reviewed in this article.

关 键 词：支架内再狭窄 冠状动脉造影 腔内影像学 诊断 治疗 

分 类 号：R54[医药卫生—心血管疾病]