何强,夏大胜,赵向东,陈欣,郭素箴,卢成志

• 1:天津医科大学第一中心临床学院
• 2:天津市第一中心医院心内科

摘要(Abstract)：

目的应用高分辨率的光学相干断层成像(OCT)对支架术后支架边缘夹层的发生率及其预后进行评价。方法选取2009年11月至2012年11月行经皮冠状动脉介入(PCI)治疗后接受OCT检查的患者,利用OCT对支架边缘的图像进行分析与测量,计算OCT观察到的支架边缘夹层的发生率,记录支架边缘夹层的撕裂深度、开口宽度、撕裂片最大长度等数据并进行分析,观察斑块的性质并随访12个月观察预后。结果入选92例患者,扫描106枚支架,纳入分析的支架边缘区域184个,最终发现18例患者的20个支架部位和24个支架边缘出现夹层,应用OCT观察PCI术后夹层发生率为19.6%,明显高于造影发现。这些患者的特征是年龄更大(P<0.001)、高血压(P=0.007)及吸烟(P=0.049)的更多,多发生于钙化斑块(P=0.002)、纤维斑块较少见(P=0.008)。随访12个月,仅被OCT发现的夹层患者与无夹层患者相比,主要不良心血管事件差异无统计学意义。结论应用OCT观察发现PCI术后夹层的发生率明显高于造影,其中仅被OCT发现的夹层预后良好。

关键词(KeyWords)： 经皮冠状动脉介入治疗;支架边缘;夹层;光学相干断层成像

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 何强,夏大胜,赵向东,陈欣,郭素箴,卢成志

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