术前血管内超声指标对冠状动脉内介入治疗患者长期预后影响

Effects of preoperative intravascular ultrasound parameters on long-term prognosis in patients with coronary artery disease who undergoing percutaneous coronary intervention

目的探讨术前血管内超声(IVUS)指标最小管腔面积(MLA)、斑块负荷(PB)对冠状动脉内介入治疗(PCI)患者长期预后的影响。方法回顾性分析2009-2016年于北部战区总医院心血管内科在IVUS指导下进行PCI的335例冠心病患者的临床资料。根据术前MLA及PB将患者分为A组(PB<70%,MLA≥4.0 mm^2;n=86)、B组(PB≥70%,MLA≥4.0 mm^2;n=112)、C组(PB<70%,MLA<4.0 mm^2;n=32)、D组(PB≥70%,MLA<4.0 mm^2;n=105)。比较各组患者的一般资料、血管病变情况,以及各组心血管不良事件的发生情况。结果A组女性比例显著高于B组与D组,差异有统计学意义(P<0.05)。A组总胆固醇高于B组,两组比较,差异有统计学意义(P<0.05)。D组支架数量与A组、C组比较,差异有统计学意义(P<0.05)。A组和D组支架长度比较,差异有统计学意义(P<0.05)。各组患者主要不良心血管事件发生率比较,差异无统计学意义(P>0.05)。结论术前MLA、PB对在IVUS指导下接受PCI患者的长期预后无明显影响。

Objective To investigate the effects of preoperative intravascular unltrasound(IVUS)parameters,minimum lumen area(MLA)and plaque burden(PB)on long-term prognosis in patients with coronary artery disease(CAD)who undergoing percutaneous coronary intervention(PCI).Methods A retrospective study was performed on 335 cases of patients with CAD who underwent PCI under the guidance of IVUS from 2009 to 2016.According to preoperative MLA and PB,the patients were divided into Group A(PB<70%,MLA≥4.0 mm^2;n=86),Group B(PB≥70%,MLA≥4.0 mm^2;n=112),Group C(PB<70%,MLA<4.0 mm^2;n=32),Group D(PB≥70%,MLA<4.0 mm^2;n=105).The general data,vascular lesions and the incidence of cardiovascular adverse events in each group were compared.Results The proportion of women in Group A was significantly higher than that in Group B and Group D,and the difference was statistically significant(P<0.05).Total cholesterol in Group A was higher than that in Group B(P<0.05).The number of scaffolds in Group D was statistically significant compared with that in Group A and Group C(P<0.05).There were statistically significant differences in stent length between Group A and Group D(P<0.05).There was no statistically significant difference in the incidence of major adverse cardiovascular events in each group(P>0.05).Conclusion Preoperative MLA and PB have no significant effect on the long-term prognosis of patients undergoing PCI under IVUS guidance.