张英,刘健,王伟民,李琪,刘传芬,马玉良,卢明瑜,赵红

• 1:承德医学院附属医院心内科
• 2:卫计委冠脉介入基地
• 3:北京大学人民医院心内科

摘要(Abstract)：

目的通过研究前降支近段或中段临界病变接受血管内超声(intravascular ultrasound,IVUS)检查患者的临床特征,分析影响最小管腔面积(minimal lumen area,MLA)的危险因素。方法选择符合入选标准的90例患者,收集其人口学资料、病史以及实验室检查数据,进行线性回归分析,筛选出影响MLA的危险因素。进一步以MLA<4.0 mm2或≥4.0 mm2为界限进行区分,采用ROC曲线测定Logistic回归寻找到的危险因素在评价MLA中的价值。结果前降支近段或中段临界病变患者中,年龄、病变血管支数为独立危险因素。ROC曲线下面积AUC=0.686,P=0.004,95%置信区间(CI)为0.574~0.798。结论前降支近段或中段临界病变中,年龄、病变血管支数为预测MLA的独立危险因素。

关键词(KeyWords)： 临界病变;血管内超声;危险因素

Abstract:

Keywords:

基金项目(Foundation): 首都卫生发展科研专项(2014-2-4085)

作者(Author): 张英,刘健,王伟民,李琪,刘传芬,马玉良,卢明瑜,赵红

参考文献(References)：

• [1]Tobis J,Azarbal B,Slavin L.Assessment of intermediate severity coronary lesions in the catheterization laboratory.J Am Coll Cardiol,2007,49:839-848.
• [2]刘传芬,王伟民,刘健,等.血管内超声在冠状动脉临界病变诊断和介入治疗中的应用.中国循环杂志,2011,26:15-18.
• [3]Schoenhagen P,Mc Erlean ES,Nissen SE.The vulnerable coronary plaque.J Cardiovasc Nurs,2000,15:1-12.
• [4]Badimon L,Badimon JJ,Vilahur G,et al.Pathogenesis of the acute coronary syndromes and therapeutic implications.Pathophysiol Haemost Thromb,2002,32:225-231.
• [5]Dickson BC,Gotlieb AI.Towards understanding acute destabilization of vulnerable atherosclerotic plaques.Cardiovasc Pathol,2003,12:237-248.
• [6]Farb A,Burke AP,Kolodgie FD,et al.Pathological mechanisms of fatal late coronary stent thrombosis in humans.Circulation,2003,108:1701-1706.
• [7]Kawasaki M,Sano K,Okubo M,et al.Volumetric quantitative analysis of tissue characteristics of coronaryplaques after statin therapy using three-dimensional integrated backscatter intravascular ultrasound.JAm Coll Cardiol,2005,45:1946-1953.
• [8]Takayama T,Hodgson JM.Predictionof the physiologic severity of coronary lesions using 3D IVUS:validation bydirect coronary pressure measurements.Catheter Cardiovasc Interv,2001,53:48-55.
• [9]Brugaletta S,Garcia-Garcia HM,Shen ZJ,et a1.Morphology of coronary artery lesions assessed by virtual histology intravascular ultrasound tissue characterization and fractional flow reserve.Int J Cardiovasc Imaging,2012,28:221-228.
• [10]顾菲菲,吕树铮,陈韵岱,等.血管内超声技术对不稳定性心绞痛患者冠状动脉临界病变形态学评价.中国介入心脏病学杂志,2011,19:125-128.
• [11]钟玥,饶莉.血管内超声和光学相干断层成像在冠状动脉介入治疗中的应用对比.中国介入心脏病学杂志,2014,22:657-659.
• [12]Abizaid AS,Mintz GS,Mehran R,et al.Long-term follow-up after percutaneous trans luminal coronary angioplasty was not performed based on intravascular ultrasound findings:importance of lumen dimensions.Circulation,1999,100:256-261.
• [13]Abizaid A,Mintz GS,Pichard AD,et al.Clinical,intravascular ultrasound and quantitative angiographic determinants of the coronary flow reserve before and after percutaneous trans luminal coronary angioplasty.Am J Cardiol,1998,82:423-428.
• [14]Kang SJ,Lee JY,Ahn JM,et al.Validation of intravascular ultrasound-derived parameters with fractional flow reserve for assessment of coronary stenosis severity.Circ Cardiovasc Interv,2011,4:65-71.
• [15]Koo BK,Yang HM,Doh JH,et al.Optimal intravascular ultrasound criteria and their accuracy for defining the functional significance of intermediate coronary stenosis of different locations.JACC Cardiovasc Interv,2011,4:803-811.
• [16]许田,葛震,张俊杰,等.定量冠状动脉造影和血管内超声预测左冠状动脉前降支单支病变致血流储备分数<0.80的价值.中国介入心脏病学杂志,2013,21:284-289.