我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

血管内超声与定量冠脉造影应用于冠脉临界病变诊治的比较(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2017年第3期
页码:
342-345
栏目:
临床研究
出版日期:
2017-01-25

文章信息/Info

Title:
Comparative study on intravascular ultrasound and quantitative coronary angiography in diagnosis and treatment of intermediate coronary stenosis
作者:
刘 弢; 李 阳; 樊泽元; 简新闻; 季汉华
中国民航总医院心内科，北京 100123
Author(s):
LIU Tao;  LI Yang;  FAN Ze-yuan;  JIAN Xin-wen;  JI Han-hua
Department of Cardiology, General Hospital of China Civil Aviation, Beijing 100123, China
关键词:
血管内超声; 定量冠脉造影; 临界病变
Keywords:
intravascular ultrasound;  quantitative coronary angiography;  intermediate stenosis;  vulnerable plaque
分类号:
Q93.33
DOI:
-
文献标识码:
A
摘要:
目的 研究血管内超声（intravascular ultrasound,IVUS）在优化民航飞行员冠脉临界病变诊断和治疗中的应用。方法 通过定量冠脉造影（quantitative coronary angiography, QCA）和IVUS对120例飞行员患者165处冠脉临界病的最小管腔直径(minimal lumen diameter,MLD)、直径狭窄率(diamter stenosis,DS)与最小管腔面积(minimal lumen area,MLA)、面积狭窄率(area stenosis,AS)等参数进行对比分析；对IVUS提示管腔MLA<4 mm2飞行员患者的冠脉临界病变行支架植入术。结果 ①同一临界病变处QCA显示的MLD，DS及MLA，AS值均小于IVUS相应的测量值，且差异有统计学意义(P<0.01)，表明IVUS对冠脉病变狭窄定量测量方面准确性更高；②IVUS提高血栓病变（15.0% vs. 2.5%,P<0.05）和心肌桥(42.5% vs. 2.5%,P<0.01)的诊断率；③与QCA相比，IVUS直接显示介入治疗中支架的贴壁情况，指导支架扩张完全。结论 IVUS较QCA能更准确地检测冠脉临界病变范围，更灵敏地诊断血栓和心肌桥，利于全面优化临界病变的诊疗。
Abstract:
AIM To study the clinical value of intravascular ultrasound (IVUS) in diagnosis and treatment of intermediate lesions in airline pilots with coronary intermediate stenosis. METHODS The parameters of 165 coronary intermediate stenoses in 120 patients including minimum lumen diameter (MLD), diameter stenosis (DS), minimum lumen area (MLA) and area stenosis (AS) were evaluated and compared, respectively, by quantitative coronary angiography (QCA) and IVUS. Stent implantation was performed on patients with MLA<4 mm2 calculated by IVUS. RESULTS MLD, MLA, AS and DS by QCA were significantly lower than those by IVUS (P<0.01), indicating IVUS was more accurate in evaluating intermediate coronary stenosis. IVUS enhanced the diagnosis rates of thrombus (15.0% vs. 2.5%, P=0.05) and myocardial bridging (42.50% vs. 2.5%, P<0.01). IVUS was superior to QCA in showing stent placement and deployment. CONCLUSION In the diagnosis and treatment of intermediate stenosis, IVUS is superior in detecting the severity of intermediate stenosis, diagnosing thrombus and myocardial bridging and optimizing safer clinical treatment strategies.

参考文献/References

[1]Fearon WF.Invasive coronary physiology for assessing intermediate lesions[J].Circ Cardiovasc Interv,2015, 8(2):e001942.
[2]Liu W,Zhang Y,Yu CM,et al.Current understanding of coronary artery calcification[J].J Geriatr Cardiol,2015,12(6):668-675.
[3]Basra SS,Virani SS,Paniagua D,et al.Acute coronary syndromes:unstable angina and non-ST elevation myocardial infarction[J].Cardiol Clin,2014,32(3):353-370.
[4]Ben Ahmed H,Bouzouita K,Boussaid H,et al.[Role of intravascular ultrasound(IVUS)in determining the therapeutic strategy for the patients with intermediate coronary lesions][J].Tunis Med,2014,92(3):224-228.
[5]Arnett DK,Goodman RA,Halperin JL,et al.AHA/ACC/HHS strategies to enhance application of clinical practice guidelines in patients with cardiovascular disease and comorbid conditions: from the American Heart Association, American College of Cardiology,and US Department of Health and Human Services[J].Circulation,2014,130(18):1662-1667.
[6]Serruys PW,Degertekin M,Tanabe K,et al.Vascular responses at proximal and distal edges of paclitaxel-eluting stents:serial intravascular ultrasound analysis from the TAXUS II trial[J].Circulation,2004,109(5):627-633.
[7]Nallamothu BK,Spertus JA,Lansky AJ,et al.Comparison of clinical interpretation with visual assessment and quantitative coronary angiography in patients undergoing percutaneous coronary intervention in contemporary practice: the Assessing Angiography(A2)project[J].Circulation,2013,127(17):1793-1800.
[8]Fernandes MR,Silva GV,Caixeta A,et al.Assessing intermediate coronary lesions:angiographic prediction of lesion severity on intravascular ultrasound[J].J Invasive Cardiol,2007,19(10):412-416.
[9]Garcia-Garcia HM,Gogas BD,Serruys PW,et al.IVUS-based imaging modalities for tissue characterization:similarities and differences[J].Int J Cardiovasc Imaging,2011,27(2):215-224.
[10]Taki A,Roodaki A,Setarehdan SK,et al.An IVUS image-based approach for improvement of coronary plaque characterization[J].Comput Biol Med,2013,43(4):268-280.
[11]Li X,Zhang G,Zhang H.Comparison of position, morphology and calcification of Coronary Plaque with 320-row dynamic volume CT (DVCT)and coronary angiography(CAG)[J].Pak J Med Sci,2014,30(4):824-829.
[12]Leening MJ,Elias-Smale SE,Kavousi M,et al.Coronary calcification and the risk of heart failure in the elderly: the Rotterdam Study[J].JACC Cardiovasc Imaging,2012,5(9):874-880.
[13]Lee CS,Seo YH,Yang DJ,et al.Positive Vascular Remodeling in Culprit Coronary Lesion is Associated With Plaque Composition:An Intravascular Ultrasound-Virtual Histology Study[J].Korean Circ J,2012,42(11):747-752.
[14]Nissen SE,Yock P.Intravascular ultrasound: novel pathophysiological insights and current clinical applications[J].Circulation,2001,103(4):604-616.
[15]Pu J,Mintz GS,Brilakis ES,et al.In vivo characterization of coronary plaques:novel findings from comparing greyscale and virtual histology intravascular ultrasound and near-infrared spectroscopy[J].Eur Heart J,2012,33(3):372-383.
[16]Siegel RJ,Ariani M,Fishbein MC,et al.Histopathologic validation of angioscopy and intravascular ultrasound[J].Circulation,1991,84(1):109-117.
[17]Abizaid A,Pichard AD,Mintz GS,et al.Intravascular-ultrasound-guided percutaneous transluminal coronary angioplasty/provisional stent implantation strategy:impact on long-term clinical follow-up[J].Int J Cardiovasc Intervent,2001,4(2):107-114.
[18]Zhang YJ,Pang S,Chen XY,et al.Comparison of intravascular ultrasound guided versus angiography guided drug eluting stent implantation: a systematic review and meta-analysis[J].BMC Cardiovasc Disord,2015,15(1):153.
[19]Elgendy IY,Mahmoud AN,Elgendy AY,et al.Outcomes With Intravascular Ultrasound-Guided Stent Implantation:A Meta-Analysis of Randomized Trials in the Era of Drug-Eluting Stents[J].Circ Cardiovasc Interv,2016,9(4):e003700.

备注/Memo

备注/Memo:
收稿日期：2016-03-16.通讯作者：季汉华，主任医师，主要从事冠心病和心力衰竭研究 Email:jihanhua@sohu.com 作者简介：刘弢，主治医师，硕士 Email:mhyy_lt@163.com
更新日期/Last Update: 2017-02-20