VH-IVUS在冠状动脉粥样硬化性心脏病临界病变介入治疗中的临床研究  

Clinical Investigation of VH-IVUS in the Intervention of Critical Lesions of Coronary Atherosclerotic Heart Disease

作　　者：梁庆辉 梅立冬 陈宇 王石 刘篪 耿爽 陈太鸿 LIANG Qinghui;MEI Lidong;CHEN Yu;WANG Shi;LIU Chi;GENG Shuang;CHEN Taihong(Beidahuang Group Hongxinglong Hospital,Shuangyashan 155811,Heilongjiang,China)

机构地区：[1]北大荒集团红兴隆医院,双鸭山市155811

出　　处：《中国分子心脏病学杂志》2023年第1期5167-5171,共5页Molecular Cardiology of China

基　　金：黑龙江省卫生健康委科研课题(2020-208)。

摘　　要：目的探究虚拟组织学-血管内超声(virtual histology-intravascular ultrasound,VH-IVUS)在冠状动脉粥样硬化性心脏病临界病变介入治疗中的临床效果。方法选取2018年1月至2020年10月行冠脉造影检查确定为冠状动脉粥样硬化性心脏临界病变的108例患者为研究对象,退出8例,最终入选100例。采用随机数字表将其分为试验组与对照组,每组各50例。试验组在冠状动脉造影后行VH-IVUS检查,根据VH-IVUS检查结果,以冠状动脉最小管腔面积<4.0 mm2及斑块负荷>70%为冠状动脉支架植入标准,给予冠状动脉支架治疗,否则药物治疗;对照组根据冠状动脉造影诊断结果结合术者临床经验给予冠状动脉支架植入或药物治疗。观察两组患者胸闷、心悸等临床症状以及心功能等级改变情况,并对两组治疗效果进行分析比较。结果试验组总有效率92.00%,显著高于对照组的76.00%,差异有统计学意义(P<0.05)。治疗前,两组患者的心绞痛发作次数、维持时长相比无差异(P>0.05),但治疗后试验组发作次数、维持时长均低于对照组(P<0.05)。结论VH-IVUS可检测易损斑块,能够预测未来不良冠状动脉事件,优化冠状动脉介入治疗。Objective To investigate the clinical effect of virtual histology-intravascular ultrasound(VH-IVUS)in the interventional treatment of critical lesions of coronary atherosclerotic heart disease.Methods A total of 108 patients with coronary atherosclerosis confirmed by coronary angiography from January 2018 to Octorber 2020 were selected,8 patients were withdrawn and 100 patients were enrolled.They were randomly divided into experimental group and control group,with 50 cases in each group.In the experimental group,VH-IVUS was performed after coronary angiography,and the minimal lumen area of the coronary artery was<4.0 mm2 according to the VH-IVUS findings and plaque burden>70%as the standard of care for coronary stent implantation given coronary stent treatment,otherwise drug treatment.The control group was given coronary stent implantation or drug treatment according to the diagnostic results of coronary angiography combined with the clinical experience of the operators.The treatment effects of the two groups were analyzed and compared.Clinical symptoms such as chest tightness and palpitations as well as changes of cardiac function grade were observed to judge the treatment effect.Results The overall effective rate of 92.00%in the experimental group was significantly higher than the 76.00%in the control group(P<0.05).There was no difference in angina pectoris between groups before treatment(P>0.05),but the number of episodes and maintenance duration in the experimental group after treatment were significantly lower than in the control group(P<0.05).Conclusion VH-IVUS can detect vulnerable plaques,predict adverse coronary events,and optimize coronary intervention.

关 键 词：冠状动脉粥样硬化性心脏病 虚拟组织学-血管内超声 临界病变 介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]