中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2011年
7期
703-705
,共3页
血管内超声%冠状动脉疾病%介入治疗%左主干病变
血管內超聲%冠狀動脈疾病%介入治療%左主榦病變
혈관내초성%관상동맥질병%개입치료%좌주간병변
Intravascular ultrasound%Coronary artery disease%Interventional therapy%Left main coronary stenosis
目的 评价血管内超声显像(IVUS)在介入治疗左主干病变中的应用价值.方法 对左主干病变63例患者进行IVUS检查,根据IVUS面积狭窄率进行分组,IVUS面积狭窄率I>50%为介入治疗组(33例)及IVUS面积狭窄率<50%为对照组(30例).介入治疗组采取介入干预治疗;对照组采取常规药物治疗.观察IVUS面积狭窄率及斑块的特征,并进行随访观察并发症.结果 介入治疗组斑块性状以软斑块及偏心性斑块为主,介入治疗中无明显的并发症,随访1年,介入治疗组再发心绞痛4例(12.1%).对照组发生再发心脏事件18例(60.0%),其中发生心绞痛6例,阵发性室速5例,急性心肌梗死3例(均行IVUS,显示左主干为罪犯血管),频发室性期前收缩3例,猝死1例.2组患者心脏事件发生率比较差异有统计学意义(x2=13.81,P<0.01).结论 IVUS对左主干的狭窄程度及指导介入治疗有一定的价值,对IVUS面积狭窄率≥50%的病变进行介入治疗预后良好.
目的 評價血管內超聲顯像(IVUS)在介入治療左主榦病變中的應用價值.方法 對左主榦病變63例患者進行IVUS檢查,根據IVUS麵積狹窄率進行分組,IVUS麵積狹窄率I>50%為介入治療組(33例)及IVUS麵積狹窄率<50%為對照組(30例).介入治療組採取介入榦預治療;對照組採取常規藥物治療.觀察IVUS麵積狹窄率及斑塊的特徵,併進行隨訪觀察併髮癥.結果 介入治療組斑塊性狀以軟斑塊及偏心性斑塊為主,介入治療中無明顯的併髮癥,隨訪1年,介入治療組再髮心絞痛4例(12.1%).對照組髮生再髮心髒事件18例(60.0%),其中髮生心絞痛6例,陣髮性室速5例,急性心肌梗死3例(均行IVUS,顯示左主榦為罪犯血管),頻髮室性期前收縮3例,猝死1例.2組患者心髒事件髮生率比較差異有統計學意義(x2=13.81,P<0.01).結論 IVUS對左主榦的狹窄程度及指導介入治療有一定的價值,對IVUS麵積狹窄率≥50%的病變進行介入治療預後良好.
목적 평개혈관내초성현상(IVUS)재개입치료좌주간병변중적응용개치.방법 대좌주간병변63례환자진행IVUS검사,근거IVUS면적협착솔진행분조,IVUS면적협착솔I>50%위개입치료조(33례)급IVUS면적협착솔<50%위대조조(30례).개입치료조채취개입간예치료;대조조채취상규약물치료.관찰IVUS면적협착솔급반괴적특정,병진행수방관찰병발증.결과 개입치료조반괴성상이연반괴급편심성반괴위주,개입치료중무명현적병발증,수방1년,개입치료조재발심교통4례(12.1%).대조조발생재발심장사건18례(60.0%),기중발생심교통6례,진발성실속5례,급성심기경사3례(균행IVUS,현시좌주간위죄범혈관),빈발실성기전수축3례,졸사1례.2조환자심장사건발생솔비교차이유통계학의의(x2=13.81,P<0.01).결론 IVUS대좌주간적협착정도급지도개입치료유일정적개치,대IVUS면적협착솔≥50%적병변진행개입치료예후량호.
Objective To evaluate the clinical application value of intravascular ultrasound(IVUS) in the treatment of left main coronary stenosis. Methods Sixty-three patients with left main coronary stenosis were identified by IVUS to evaluate the plaque characteristics and the severity of the stenosis. According to the severity of the stenosis,the patients were divided into percutaneous coronary intervention ( PCI) group (IVUS=50% ) (n = 33 ) and control group (IVUS < 50% ) (n = 30). The group of PCI was treated by PCI. The control group was treated by routine therapeutic agents. The profiles of plaques and stenosis were described. The complications were recorded by follow-up visits. Results More soft and eccentric plaques were found in PCI group. After one year follow up,cardiac events (angina) occurred in 4 cases (12. 1% ) in PCI group. In control group, cardiac events ocurred in 18 patients (60. 0%), including 6 cases of angina, 5 case of paroxysmal ventricular tachycardia,3 cases of myocardial infarction (confirmed by IVUS,showing that the left main coronary artery was responsible for the event), 3 cases of frequent premature ventricular contraction and 1 case of sudden death. There was a significant difference in the occurrence rate of cardiac events between PCI group and non-PCI group (x2 = 13. 81 ,P <0.01). Conclusion IVUS is useful for the identification and treatment guidance. Intervention therapy produces good prognosis in patients with IVUS-identified left main coronary stenosis by more than 50% of the area.
