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目的:探讨血管内超声(IVUS)在冠状动脉(冠脉)造影显示的临界病变诊断和介入治疗中的应用价值。方法:对经选择性冠脉造影提示临界病变的96例患者的110处病变进行IVUS检查,根据IVUS测定的最小管腔面积≤4.0 mm2作为冠脉介入治疗的标准,分为干预组和未干预组,分析病变的狭窄程度及粥样硬化斑块性质。结果:110处临界病变的平均最小管腔面积为(4.83±2.24)mm2,46处最小管腔面积≤4.0 mm2的病变成功置入冠脉支架;IVUS显示干预组的最小管腔面积小于未干预组(3.47±0.44)mm2比(5.69±1.57)mm2,(P<0.05);同时干预组的斑块负荷大于未干预组,但差异无统计学意义(68.50±5.98)%比(62.89±7.69)%,(P>0.05)。两组的定性结果差异无统计学意义(P>0.05)。结论:对冠脉造影显示的临界病变行IVUS检查可进一步明确临界病变的狭窄程度和病变的性质,指导下一步治疗。
Objective: To investigate the value of intravascular ultrasound (IVUS) in the diagnosis and interventional treatment of critical lesions revealed by coronary (coronary) angiography. Methods: One hundred and sixty-six lesions in 96 patients undergoing selective coronary angiography (CAG) were examined by IVUS. According to IVUS, the smallest lumen area ≤4.0 mm2 was used as the standard of coronary intervention. The intervention group and intervention group Groups were analyzed for the degree of stenosis and the nature of atherosclerotic plaques. Results: The mean minimum lumen area at 110 critical lesions was (4.83 ± 2.24) mm2, and the minimal lumen area ≤4.0 mm2 at 46 lesions was successfully placed in coronary stents. IVUS showed that the minimum lumen area in intervention group was smaller than that without intervention (3.47 ± 0.44) mm2 vs (5.69 ± 1.57) mm2, respectively (P <0.05). The plaque load in intervention group was higher than that in non-intervention group (68.50 ± 5.98)% (62.89 ± 7.69) )%, (P> 0.05). There was no significant difference in the qualitative results between the two groups (P> 0.05). Conclusion: The IVUS examination of critical lesions revealed by coronary angiography can further clarify the degree of stenosis of critical lesions and the nature of lesions, and guide the next treatment.