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目的:探讨血管内超声对稳定型心绞痛(SAP)患者冠状动脉(冠脉)病变斑块结构与血管重构关系的评估价值。方法:在冠脉介入治疗前应用血管内超声对SAP患者的冠脉病变进行研究。根据测定的重构指数(RI)将患者分为A组(负重构,RI<1.0)和B组(正重构,RI≥1.0),根据管腔面积狭窄率分为管腔面积狭窄率<70%组(轻中度狭窄组)和管腔面积狭窄率≥70%组(重度狭窄组)。结果:①与A组比较,B组近端参考段斑块负荷小,病变处的管腔面积和外弹力膜面积大、斑块负荷小,硬斑块所占比例少,病变处最大钙化弧度和长度小;②与轻中度狭窄组比较,重度狭窄组负重构多,软斑块少,病变处管腔面积小,病变处斑块面积和斑块负荷大,RI偏小,病变最大钙化弧度大。结论:不同程度管腔狭窄的SAP患者中,斑块钙化在负重构和严重管腔狭窄中占优势,负重构更常见于严重狭窄病变。
Objective: To evaluate the value of intravascular ultrasound in detecting the relationship between plaque structure and vascular remodeling in coronary artery (coronary artery) patients with stable angina pectoris (SAP). Methods: Coronary lesions in SAP patients were studied by intravascular ultrasound before coronary intervention. The patients were divided into group A (negative remodeling, RI <1.0) and group B (positive remodeling, RI≥1.0) according to the measured RI. According to the stenosis rate, the stenosis rate <70% group (mild to moderate stenosis group) and lumen stenosis rate≥70% group (severe stenosis group). Results: ①Compared with group A, the proximal reference segment in group B had a lower plaque load, a larger luminal area and a larger eardrum area, a lower plaque load, a smaller proportion of hard plaque, and a maximum calcification curvature at the lesion Compared with mild to moderate stenosis group, severe stenosis group had more negative remodeling, less soft plaque, less lumen area, larger plaque area and plaque burden, smaller RI, and larger lesions Calcification of large arc. Conclusions: Plaque calcification predominates in negative remodeling and severe lumen stenosis in patients with varying degrees of stenosis. Negative remodeling is more common in severe stenosis.