汤喆,甄雷,阙斌,艾辉,张新勇,赵雪东,师树田,聂绍平

• 1:首都医科大学附属北京安贞医院急诊危重症抢救中心

摘要(Abstract)：

目的利用血管内超声(IVUS)评价冠状动脉远端血管弹性对慢性完全闭塞(CTO病变开通后出现无复流或血流减慢的影响。方法回顾性分析2017年10月至2018年12月在首都医科大学附属北京安贞医院急诊中心行经皮冠状动脉介入治疗并成功置入支架完成IVUS检查的CTO病变患者34例。支架置入后远端血流正常组26例[心肌梗死溶栓治疗试验(TIMI)血流分级≥Ⅱ级],血流减慢组8例(TIMI血流分级0级或Ⅰ级)。分析可能导致无复流的病变形态学特点。结果两组患者血管钙化、中膜血肿、导丝行走于内膜下等比较,差异均无统计学意义(均P>0.05)。血流正常组的远端参考管腔面积[(4.09±1.71)mm2比(2.70±0.86)mm2,P=0.036]、远端血管收缩面积比[(15.96±3.95)%比(7.26±1.62)%,P=0.020]显著高于血流减慢组。logistic回归分析显示,远端血管弹性差(OR 13.75,95%CI 1.946～97.178,P=0.009)是支架置入后远端无复流及血流受限的独立预测因素。结论 IVUS观察的CTO病变远端血管弹性是影响CTO病变开通后远端出现无复流的独立危险因素。

关键词(KeyWords)： 慢性完全闭塞;经皮冠状动脉介入治疗;血管内超声;血管弹性

Abstract:

Keywords:

基金项目(Foundation): 北京市医管局重点医学专业发展计划（ZYLX201710）;北京市医管局“登峰”人才培养计划（DFL20180601）;; 心血管疾病精准医学北京实验室(PXM2018_014226_000013)

作者(Author): 汤喆,甄雷,阙斌,艾辉,张新勇,赵雪东,师树田,聂绍平

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