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目的:回顾性分析61例患者血管内超声(IVUS)的结果,明确IVUS临床意义。方法:对入选的61例患者IVUS术前均行冠状动脉造影,然后对病变部位斑块特点进行定性、定量分析。结果:2例患者血管壁光滑或仅少量内膜增生;34例为软斑块;10例纤维斑块;6例钙化斑块;支架内膜增生5例;斑块破裂2例;壁内血肿1例;动脉瘤样扩张1例。急性冠状动脉综合征以软斑块(脂质斑块)为主,多数发生阳性重塑,血管腔偏心明显;而阴性重塑者纤维、钙化斑块比例较大。比较中度狭窄病变的肉眼,计算机定量冠状动脉成像及IVUS测量的病变狭窄程度,发现肉眼观察的病变狭窄程度最高,IVUS测得的面积狭窄率最小。结论:与冠状动脉造影相比,IVUS能更加精细地观察血管壁的斑块性质和病变特点。
Objective: To retrospectively analyze the results of 61 patients with intravascular ultrasound (IVUS) and clarify the clinical significance of IVUS. Methods: Sixty-one patients underwent IVUS before coronary angiography, and then qualitative and quantitative analysis of plaque characteristics of the lesion. Results: The vascular wall was smooth or only a small amount of intimal hyperplasia was found in 2 cases. Soft plaque was found in 34 cases, fibrous plaque in 10 cases, calcified plaque in 6 cases, plaque in 5 cases, plaque rupture in 2 cases, 1 case; aneurysmal dilatation in 1 case. Acute coronary syndrome with soft plaque (lipid plaque), the majority of positive remodeling, obvious vascular eccentricity; and negative remodeling fibers, calcified plaque a larger proportion. Comparing the severity of moderate and severe lesions with computer-assisted coronary angiography and IVUS measurement of stenosis, it was found that macroscopic lesions showed the highest degree of stenosis with minimal IVUS area stenosis. Conclusion: Compared with coronary angiography, IVUS can observe the plaque quality and lesion characteristics of vascular wall more finely.