血管内超声衰减斑块的研究进展  

Attenuated Plaque Identified by Intravascular Ultrasound

作　　者：林子健 许俊炜 陈剑[1] 陈柏荣[1] 罗礼云[1] LIN Zijian;XU Junwei;CHEN Jian;CHEN Bairong;LUO Liyun(Cardiovascular Center,The Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,Guangdong,China)

机构地区：[1]中山大学附属第五医院心血管病中心,广东珠海519000

出　　处：《心血管病学进展》2023年第4期312-315,320,共5页Advances in Cardiovascular Diseases

摘　　要：衰减斑块是血管内超声识别的伴有超声衰减现象的易损斑块特征之一,其主要病理特征为具有巨大脂质坏死核心,衰减斑块成分中的胆固醇结晶及点状钙化对超声的折射和吸收导致超声波无法穿过斑块而表现为超声衰减现象,常见于急性冠脉综合征,与冠心病患者主要不良心血管事件增加相关,且增加经皮冠状动脉介入治疗术中无复流、围手术期心肌坏死及斑块脱垂等并发症的发生风险。现从衰减斑块的定义、病理机制、临床意义、预后及临床治疗策略等方面进行综述,同时对人工智能及血管内超声/光学相干断层扫描集合导管在衰减斑块领域的新技术应用方面进行展望。Attenuated plaque is one of the features of the vulnerable plaque with ultrasound attenuation phenomenon identified by intravascular ultrasound,which is characterized by containing a large lipid necrotic core.The cholesterol crystals and spotty calcification in the attenuated plaque refracted and absorbed the ultrasound,which resulted in the ultrasound unable to pass through the plaque,and led to ultrasound attenuation phenomenon.Attenuated plaque is commonly seen in patients with acute coronary syndrome,and is associated with an increased risk for major adverse cardiovascular events in patients with coronary heart disease,and increases the risk of complications such as no reflow during percutaneous coronary intervention,perioperative myocardial necrosis and plaque prolapse.In this paper,we will review the definition,pathological mechanism,clinical significances,prognosis and clinical treatment strategies of coronary ultrasound attenuated plaque,and prospect the application of artificial intelligence and intravascular ultrasound/optical coherence tomography converging catheter in the field of coronary ultrasound attenuated plaque.

关 键 词：冠心病 经皮冠状动脉介入治疗 血管内超声 衰减斑块 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]