可疑冠心病冠状动脉造影和血管内超声的对比研究  

Comparative study of intravascular ultrasound and coronary angiography in diagnosis of patients with suspected coronary aretery disease

作　　者：王彬尧[1] 韩志华[1] 厉锦华[1] 王长谦[1] 张清[1] 刘建平[1] 郑道声[1] 

机构地区：[1]上海第二医科大学附属仁济医院心内科,200001

出　　处：《上海医学》2003年第9期654-656,T003,共4页Shanghai Medical Journal

摘　　要：目的　探讨血管内超声 (IVUS)对冠心病的诊断价值。方法　对临床拟诊可疑冠心病 (CAD)、经冠状动脉造影 (CAG)发现无明显狭窄或有轻度狭窄 (直径狭窄率 <5 0 %)者行IVUS检查 ,分析比较两种方法对可疑CAD的诊断价值。结果　 2 2例中 ,CAG显示 7例无狭窄 ,15例轻度狭窄 ,而IVUS显示均有显著的各种性质的粥样斑块病变。CAG对冠状动脉狭窄程度的测定值包括直径狭窄率 (2 1.17± 10 .93) %和面积狭窄率(37.0 5± 19.14) %,显著低于IVUS测得的 (37.87± 10 .0 7) %和 (5 7.87± 13.93) %(P值分别为 0 .0 0 6和0 .0 0 1)。IVUS对离心性、钙化、左主干、分叉部位和弥漫性病变的检出率显著高于CAG(P <0 .0 5 )。结论　CAG明显低估了冠状动脉病变的严重程度 ,IVUS对可疑冠心病的诊断具有重要的临床价值 ,为选择治疗方案提供了临床客观依据。Objective To appraise the value of intravascular ultrasound (IVUS) in early diagnosis of patients with suspected coronary aretery disease (CAD).Methods Coronary angiography (CAG) was performed in all patients with suspected CAD, and IVUS in case when CAG showing insignificant stenosis. The diagnotic value of the two methods for suspected CAD was then analysed and compared.Results In 22 patients, CAG showed no stenosis in 7 cases and mild stenosis in 15, but IVUS could discover significant and various kinds of atheromatous plaques. The degree of arterial stenosis (percentages of stenosed arterial diameter and area) in CAG was significantly less well shown than those by IVUS (21.17%±10.93% vs 37.87%±10.07%,P=0.006;37.05%±19.14% vs 57.87% ±13.93%,P=0.001, respectively). The rates of detection with IVUS were more than those with CAG for calcified lesion, eccentric lesion, diffuse lesion and lesions in left main trunk and bifurcation(P<0.05). Conclusion CAG significantly underestimates the degree of vascular lesions. IVUS has important clinical value in the early diagnosis of suspected CAD and provides objective evidences for option of therapeutic regimes.

关 键 词：冠心病 冠状动脉造影 血管内超声 对比研究 诊断 

分 类 号：R445[医药卫生—影像医学与核医学]