血管内超声指导下对小血管病变的介入治疗

Intravascular ultrasonography-guided intervention therapy for small vessel lesions

目的：评价血管内超声（IVUS）对小血管病变介入治疗的临床意义。方法回顾性分析2010年10月～2013年2月于我院接受介入治疗的单支小血管（≤2．5mm）病变患者共237例，其中，IVUS指导下介入治疗的患者105例（Ⅰ组），冠状动脉造影（CAG）指导下介入治疗的患者132例（Ⅱ组）。分析2组患者基线资料、病变特点、介入治疗及随访期间心脏不良事件和再狭窄情况。结果2组患者介入治疗均成功，Ⅰ组和Ⅱ组置入支架直径[（2．50±0．40）mmvs（2．34±0．37）mm]、支架长度[（28．75±7．77）mmvs（35．78±10．45）mm]、支架高压后扩张（91．4％vs55．3％）和支架内再狭窄（1．9％vs7．6％）比较，差异有统计学意义（P＝0．002，P＝0.000，P＝0．000，P＝0.042）；2组串联支架、CAG随访比较差异无统计学意义（P＞0．05）。2组患者住院及随访1、3和6个月期间，均无主要不良心脏事件发生。结论对于小血管病变的介入治疗，IVUS具有较好的指导作用。

Objective To assess the clinical significance of intravascular ultrasonography （IVUS）-guided intervention therapy for small vessel lesions .Methords Two hundred and thirty-seven patients who underwent intervention therapy for single vessel （≤2 .5 mm） lesions in our hospital from October 2010 to February 2013 were divided into IVUS-guided intervention therapy group （n=105）and coronary ateriography-guided group （n=132） .Their baseline parameters ,lesion features ,main adverse cardiac events （MACE） and restenosis during follow-up were analyzed . Results Intervention therapy for the two groups was successful .The diameter ,length ,dilation and restenosis of stents were significantly different between the two groups （ P= 0 .002 ,P=0.000 ,P= 0.000 ,P= 0 .042） .However ,no significant difference was found in the incidence of series stent and MACE during follow-up （P〉0 .05） .Conclusion IVUS plays an important role in intervention therapy for small vessel lesions .