急性冠脉综合征的血管内超声研究

Study on Acute Coronary Syndromes with Intravascular Ultrasonic

目的:探讨急性冠脉综合征(ACS)易损斑块的血管内超声(IVUS)特点。方法:在35例ACS(其中不稳定性心绞痛24例,急性心肌梗死11例)和23例稳定性心绞痛患者中进行冠状动脉IVUS检查,测量病变部位的血管外弹力膜面积(EEMA)、斑块面积(PA)及斑块负荷(PA),并计算斑块的偏心指数(EI)及血管的重构指数(RI)。结果:在58例患者中发现,16例ACS患者和5例稳定性心绞痛患者发生斑块破裂;与稳定性心绞痛组比较,不稳定心绞痛的斑块具有较大的偏心性(P<0.05),EEMA、PA、PB、RI明显大于前者,具有显著的统计学意义(P均<0.001)。结论IVUS能够准确地识别ACS易损斑块及其破裂和血栓形成。

Objective To identify the characteristic features of vulnerable atherosclerotic plaques with intravascular ultrasound （IVUS）. Methods Fifty-eight patients with acute coronary syndromes underwent coronary IVUS examinations, of which 24 patients were unstable angina, 11 patients were acute myocardial infarction and 23 were stable angina. IVUS was used to analyze the qualities of the plaques and then measure the external elastic membranearea （EEMA）, plaque area （PA） and plaque burden（ PB% ）, respectively, and lumen eccentricity index and remodeling index were calculated. Results Sixteen lesions in ACS patients occurred plaque ruptures. There were more eccentric plaques in ACS groups than that in stable angina group （ P 〈 O. 05 ）, and EEMA, PA , PB and RI in the ACS groups were larger than those of stable angina group （ P 〈 0. 001 respectively）. Conclusion IVUS can detect vulnerable atherosclerotic plaques and plaque ruptures.