冠状动脉造影显示造影剂排空滞缓段的血管内超声研究

Intravascular ultrasound study on angiographic cont rast materiel drain-lagged coronary segments

目的:探讨造影剂排空滞缓的冠状动脉段的病变结构特点及其临床意义。方法:对23例冠状动脉造影(CAG)显示造影剂充盈缓慢且排空滞缓的血管行血管内超声检查,分析斑块性质、测量面积狭窄率及计算重构指数。结果:与参照血管段比较,病变处血管面积[(17·04±3·86)mm2vs(14·35±3·62)mm2,P<0·01]及血管腔面积[(13·72±2·38)mm2vs(11·86±2·57)mm2,P<0·01]均显著增加,并有软斑块,狭窄程度较轻(19·48%±5·23%)。23处病变20处为正重构,重构指数为1·21±0·07。结论:小的粥样硬化斑块及正重构是导致造影剂排空滞缓的原因,这种病变具有不稳定的结构特点。

Objective： To investigate the clinical significant and structural characteristics of angiographic contrast materiel drain-lagged coronary segments. Method：Twenty-three segments of coronary arteries in 23 patients with angiographic contrast materiel drain-lagged were examined by intravascular ultrasound （IVUS） imaging. The characteristics of the plaques and reference segments were analyzed. Percent area stenosis and remodeling index were calculated. Result： External elastic membrane cross-sectional area in angiographic contrast materiel drain-lagged segments were greater than reference segments [ （ 17.04 ± 3.86）mm^2 vs （ 14.35 ± 3.62）mm^2 , P 〈 0.01 ]. Compared with reference segments, lesions had greater lumenal area [ （ 13.72 ± 2.38） mm^2 vs （ 11.86 ± 2.57 ） mm^2 , P 〈 0.01 ]. Soft plaque, minor stenosis（percent area stenosis 19.48% ± 5.23%） and positive remodeling were the more frequently findings（20/23,87 % ） in contrast agient drnin-lagged segments. Conclusion：Positive remodeling and minor atherosclerosis plaque cause segmental angiographic contrast materiel drain-lagged. This lesion has structural characteristics of unstable plaque.