中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2009年
8期
721-724
,共4页
金泽宁%吕树铮%陈韵岱%苑飞%宋现涛%吴小凡%张丽洁%任芳%葛长江%汪国忠%胥学伟
金澤寧%呂樹錚%陳韻岱%苑飛%宋現濤%吳小凡%張麗潔%任芳%葛長江%汪國忠%胥學偉
금택저%려수쟁%진운대%원비%송현도%오소범%장려길%임방%갈장강%왕국충%서학위
冠状动脉疾病%糖尿病%冠状血管造影术%超声检查%介入性
冠狀動脈疾病%糖尿病%冠狀血管造影術%超聲檢查%介入性
관상동맥질병%당뇨병%관상혈관조영술%초성검사%개입성
Coronary disease%Diabetes mellitus%Coronary angiography%Ultrasound,interventional
目的 对比血管内超声(IVUS)与定量冠状动脉造影(QCA)对于冠心病合并糖尿病患者靶病变和参考血管定量测量结果,评价QCA的准确性,以指导临床的干预治疗.方法 2型糖尿病患者52例,男35例,女27例,年龄(62.3±7.1)岁.接受QCA和IVUS检查.以IVUS测量最小面积处斑块负荷结果作为因变量,以QCA定量测量的病变血管狭窄程度作为自变量,进行相关和回归分析,得到相关系数,建立回归方程.并对比近、远端参考血管直径两类方法测量值.结果 QCA冠状动脉狭窄程度测量结果同IVUS最小面积处斑块负荷结果的回归方程(斜率:0.8286,P=0.001)显示二种方法的测量结果有明确的同步变化趋势和相关性(r=0.691,P＜0.001).但QCA测量结果(57.9%±15.5%)较ivus(53.5%±12.9%)高估了病变的严重程度(差值为4.6%±1.2%).本组患者为血管负性重构,重构指数(RI)为0.87±0.23.相对于近、远端参考血管的管腔直径测量误差[(0.24±0.06)mm和(0.07±0.01)mm]而言,QCA对近、远端参考血管的血管直径的测量误差[(0.81±0.24)mm和(0.64±0.17)mm]更为明显.结论由于糖尿病患者广泛的血管重构(尤其是负性重构),使QCA易高估罪犯血管严重程度.同时,QCA因无法准确显示斑块负荷,而导致造影显示为"正常"血管段,从而低估近远端参考血管直径.
目的 對比血管內超聲(IVUS)與定量冠狀動脈造影(QCA)對于冠心病閤併糖尿病患者靶病變和參攷血管定量測量結果,評價QCA的準確性,以指導臨床的榦預治療.方法 2型糖尿病患者52例,男35例,女27例,年齡(62.3±7.1)歲.接受QCA和IVUS檢查.以IVUS測量最小麵積處斑塊負荷結果作為因變量,以QCA定量測量的病變血管狹窄程度作為自變量,進行相關和迴歸分析,得到相關繫數,建立迴歸方程.併對比近、遠耑參攷血管直徑兩類方法測量值.結果 QCA冠狀動脈狹窄程度測量結果同IVUS最小麵積處斑塊負荷結果的迴歸方程(斜率:0.8286,P=0.001)顯示二種方法的測量結果有明確的同步變化趨勢和相關性(r=0.691,P＜0.001).但QCA測量結果(57.9%±15.5%)較ivus(53.5%±12.9%)高估瞭病變的嚴重程度(差值為4.6%±1.2%).本組患者為血管負性重構,重構指數(RI)為0.87±0.23.相對于近、遠耑參攷血管的管腔直徑測量誤差[(0.24±0.06)mm和(0.07±0.01)mm]而言,QCA對近、遠耑參攷血管的血管直徑的測量誤差[(0.81±0.24)mm和(0.64±0.17)mm]更為明顯.結論由于糖尿病患者廣汎的血管重構(尤其是負性重構),使QCA易高估罪犯血管嚴重程度.同時,QCA因無法準確顯示斑塊負荷,而導緻造影顯示為"正常"血管段,從而低估近遠耑參攷血管直徑.
목적 대비혈관내초성(IVUS)여정량관상동맥조영(QCA)대우관심병합병당뇨병환자파병변화삼고혈관정량측량결과,평개QCA적준학성,이지도림상적간예치료.방법 2형당뇨병환자52례,남35례,녀27례,년령(62.3±7.1)세.접수QCA화IVUS검사.이IVUS측량최소면적처반괴부하결과작위인변량,이QCA정량측량적병변혈관협착정도작위자변량,진행상관화회귀분석,득도상관계수,건립회귀방정.병대비근、원단삼고혈관직경량류방법측량치.결과 QCA관상동맥협착정도측량결과동IVUS최소면적처반괴부하결과적회귀방정(사솔:0.8286,P=0.001)현시이충방법적측량결과유명학적동보변화추세화상관성(r=0.691,P＜0.001).단QCA측량결과(57.9%±15.5%)교ivus(53.5%±12.9%)고고료병변적엄중정도(차치위4.6%±1.2%).본조환자위혈관부성중구,중구지수(RI)위0.87±0.23.상대우근、원단삼고혈관적관강직경측량오차[(0.24±0.06)mm화(0.07±0.01)mm]이언,QCA대근、원단삼고혈관적혈관직경적측량오차[(0.81±0.24)mm화(0.64±0.17)mm]경위명현.결론유우당뇨병환자엄범적혈관중구(우기시부성중구),사QCA역고고죄범혈관엄중정도.동시,QCA인무법준학현시반괴부하,이도치조영현시위"정상"혈관단,종이저고근원단삼고혈관직경.
Objective To evaluate the accuracy of quantitative coronary angiography ( QCA ) assessment on target lesion and reference vessel in patients with diabetes mellitus with intravascular ultrasound (IVUS) measurements as golden standard. Methods QCA and IVUS were performed in 52 diabetes mellitus patients [35 males, mean age (62.3 ±7. 1)years]. Regression equation was ascertained with the IVUS derived plaque burden as dependent and QCA derived vessel stenosis as independent variable. The measurement results derived from the two modalities on proximal and distal reference vessels were compared. Result The regression equation (constant = 0. 8286, P = 0. 001) of plaque burden and vessel stenosis derived from two modalities were significantly correlated ( r = 0. 691, P < 0. 001 ) but QCA overestimated the stenosis severity (57. 9% ± 15. 5% vs. 53. 5% ± 12. 9% , P <0. 01 ). Target vessels negative remodeling index in these patient was 0. 87 ±0.23. QCA significantly underestimated the proximal and distal reference segments vessel diameters [ ( 0. 81 ± 0. 24 ) mm, ( 0. 64 ± 0. 17 ) mm, all P < 0. 05 ] as compared to IVUS results. Conclusion Due to the significant negative vessel remodeling, QCA overestimated the stenosis severity and underestimated the reference segments vessel diameters in patients with diabetes mellitus.
