田婷,罗俊一,刘芬,单春方,李晓梅,杨毅宁

• 1:新疆医科大学第一附属医院心脏中心

摘要(Abstract)：

目的分析可疑编织样冠状动脉患者的临床及影像学特点,探讨其治疗与预后。方法纳入6例冠状动脉造影检查发现冠状动脉呈现"编织样"或"蜂窝样"充盈缺损的患者,经光学相干断层成像(OCT)明确诊断为编织样冠状动脉3例、血栓再通3例。分析患者的临床特征、影像学资料、治疗方案,并随访观察其主要不良心脑血管事件(MACCE)发生情况以评估预后。结果编织样冠状动脉在OCT中显示为多个互不相通的小血管,血管结构完整。编织样冠状动脉患者中2例患者发生急性心肌梗死行介入治疗,1例患者为陈旧性心肌梗死伴心绞痛,接受单纯药物治疗;随访期间(中位随访时间20.5个月)均未发生MACCE。血栓再通OCT表现为多个微通道相互连通,血管壁结构不完整。血栓再通3例患者均有显著的心肌缺血症状,具备经皮冠状动脉介入治疗(PCI)适应证,均接受PCI;随访期间(中位随访时间20.5个月)有1例患者发生MACCE。结论编织样冠状动脉在结合临床表现、有效评估心肌缺血及病变程度选择合理的治疗方案后,一般可以获得较好的预后。对血栓再通患者,需根据心肌缺血证据和远端血管功能评价选择适当的治疗策略,并进行积极随访有助于预防MACCE发生。

关键词(KeyWords)： 编织样冠状动脉;冠状动脉造影;血栓再通;光学相干断层成像

Abstract:

Keywords:

基金项目(Foundation): 新疆维吾尔自治区重点研发计划项目（2020B3002、2020B3002-1）;; 新疆维吾尔自治区研究生科研创新计划项目（XJ2020G185）;; 新疆医科大学临床医学高峰学科校内配套经费资助项目（33-0104006020801#）

作者(Author): 田婷,罗俊一,刘芬,单春方,李晓梅,杨毅宁

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