血管内超声和光学相干断层成像对冠状动脉粥样硬化斑块的诊治价值

Diagnostic and therapeutic values of intravascular ultrasound and optical coherence tomography in coronary atherosclerotic plaques

冠状动脉性心脏病(CHD)亦称缺血性心脏病,其发病率和死亡率长期居世界首位。冠状动脉造影术(CAG)仍是目前诊断CHD的金标准,并广泛应用于CHD的诊疗中,但CAG的分辨率较低,对冠状动脉病变的内膜、外膜和详细病理变化的观察不够精确。血管内超声(IVUS)和光学相干断层成像(OCT)是两种分辨率较高的血管内成像技术,对CHD的诊断和介入治疗起到了很好的补充作用,目前临床上应用也日趋广泛。本文从IVUS和OCT识别冠状动脉粥样硬化斑块、指导和评价经皮冠状动脉介入术的研究现状进行综述。

Coronary heart disease (CHD), also known as ischemic heart disease, has the highest morbidity and mortality globally. Coronary angiography (CAG) is the golden standard for the diagnosis of CHD currently, and has been widely used in tackling CHD. Nevertheless, with relatively low resolution, CAG fails to observe details of the subtle structure of coronary intima, adventitia and their pathological changes. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are two intracoronary imaging techniques of high resolution which make remarkable supplement to the diagnosis and interventional therapies of CHD, and are now widely used in clinical practice. This review will elaborate the current status of IVUS and OCT in identifying coronary atherosclerotic plaques and in guiding as well as evaluating the percutaneous coronary intervention.