目的探讨冠状动脉冠脉血管内超声显像(IVUS)对冠心病的冠脉病变特点研究及在冠脉支架置入术中的应用价值。方法选择28例拟行经皮冠脉介入治疗术(PCI)患者,冠脉造影显示单支病变,在支架置入前,应用IVUS观察靶血管的斑块特点(软斑块、纤维斑块、钙化斑块及混合斑块)以及偏心程度,测量血管的最小腔径及腔面积、斑块面积,在支架置入后测量血管的最小腔径及腔面积、斑块面积,观察支架的位置,测量支架的对称指数、支架的贴壁程度及支架展开满意度。结果28例冠心病患者共置入36枚支架,在支架置入后,最小血管腔径及腔面积均较置入前增大,斑块面积缩小,差异均具有统计学意义(P<0.01),支架置入后IVUS检查所有支架位置满意,能完全覆盖病变,两端无夹层,30例支架扩张满意,3例未充分扩张,3例贴壁欠佳,占支架置入的16.7%,在更换大一号低顺应性球囊高压扩张或用原球囊更高压力扩张(18～22atm)后复查IVUS达到满意标准。结论IVUS可清晰显示冠脉内血管的斑块特点、偏心程度、血管腔径、血管腔面积及斑块面积,在支架置入前可指导选择支架的大小,支架置入后可观察支架的位置、贴壁情况,支架扩张是否充分,是评价冠脉支架置入较理想的方法。 Objective To investigate the characteristics of coronary artery lesions by coronary artery intravascular ultrasound imaging (IVUS) and its clinical value in coronary stenting. Methods 28 patients undergoing percutaneous coronary intervention (PCI) were enrolled. Coronary angiography showed a single vessel lesion. Before embedding, IVUS was used to observe the plaque characteristics of the target vessel (soft plaque, fibrous plaque, calcification Plaque and mixed plaques) and degree of eccentricity, measuring the minimum diameter of blood vessels and cavity area, plaque area, measuring the minimum lumen diameter and cavity area, plaque area, the position of the stent after measuring stent placement, measurement Symmetry index of the stent, degree of adhension of the stent and stent satisfaction. Results Totally 36 stents were placed in 28 patients with coronary heart disease. After stent implantation, the minimum vessel diameter and lumen area were increased before implantation and the area of ​​plaque was reduced. The differences were statistically significant (P0.01) After stent implantation, all stents were satisfactorily covered by IVUS, which completely covered the lesion. There was no dissection between the two stents. Thirty stents were satisfactorily expanded. Three patients did not fully expand. Three patients had poor adherence, accounting for 16.7% Replacement of the first high compliance low balloon dilation or expansion of the original balloon pressure (18 ~ 22atm) after the review of IVUS to meet the desired standard. Conclusion IVUS can clearly show the plaque features, eccentricity, vascular lumen, vascular lumen area and plaque area of ​​coronary vessels, guide the size of the stent before stent implantation, and observe the position of the stent after stent implantation , Adherent conditions, stent expansion is adequate, is to evaluate coronary stent placement more ideal way.