冠状动脉重度钙化病变斑块的形态学特征

Morphologic characteristics of the severe coronary artery calcification plaque by intravascular ultrasonography

目的利用血管内超声检查分析冠状动脉重度钙化病变斑块的形态学特点。方法选取在解放军总医院心脏介入中心行冠脉造影及血管内超声检查的108例冠心病患者,经皮冠脉介入术前对靶血管行血管内超声检查,共获得108个病变血管截段,血管内超声测量病变最小管腔处的管腔面积、斑块负荷、管腔狭窄率、最大钙化弧度,病变截段平均管腔面积,测量病变长度及病变处累计钙化长度,并计算钙化长度比及钙化指数。结果病变血管最狭窄处管腔面积,重度钙化组<轻度钙化组<非钙化组;病变血管截断平均管腔面积,重度钙化组小于另2组。病变截段管腔平均面积与钙化指数呈负相关性,相关性较钙化弧度及钙化长度强。最小管腔面积与最大钙化弧度呈负相关性,相关性较钙化长度及钙化指数强。结论重度钙化病变管腔最小面积及病变管腔平均面积均偏小。钙化指数与病变截段的平均管腔面积有较好的相关性,而钙化弧度与病变最小管腔面积有较好的相关性。

Objective To analyze the morphologic characteristics of severe coronary artery calcification plaque by intravascular ultrasonography（IVUS）. Methods 108 patients （108 target lesions）with coronary heart disease （CHD） who underwent percutaneous coronary intervention（PCI） with IVUS were analyzed. Minimum lumen cross sectional area （CSA）, external elastic membrane （EEM）, plague burden and lumen area narrowing rate, calcium arc of the maximum lumen of lesion site, reference site and every I mm of total le- sion were measured. The length of lesion and calcification were also measured, according which calcium length ratio and calcium index were calculated. Result Minimum lumen cross sectional area （CSA） and mean lumen area were smaller in severely calcified group. There was a negative relationship between calcium index and mean lumen area. The correlation between minimum lumenal area and calci- um index was stronger than calcium index and calcium length ratio. However, the correlation between mean lumen area of lesion and cal- cium index was stronger than calcium arc and calcium length ratio. Conclusion The minimum area of lumenal lesions and the average area of lumenal lesion in severe coronary artery calcification plaque are smaller. There is a good correlation between the calcification index and the mean lumenal area of the lesion;And there is a good correlation between calcification radian and the minimum lumenal area.