冠状动脉非左主干临界病变患者定量冠状动脉造影与血管内超声测值的比较

Comparison of measurements of quantitative coronary angiography and intravascular ultrasound in patients with intermediate non-left main coronary lesions

目的分析血管内超声(IVUS)与定量冠状动脉造影(QCA)对冠状动脉非左主干临界病变相关参数分析,探讨IVUS和QCA在非左主干临界病变中的诊断价值。方法入选2017年9月至2019年12月在湖州市中心医院心内科行冠状动脉造影提示为非左主干临界病变患者102例,对所有病变部位分别行QCA及IVUS测量,测量相关参数包括病变处最小管腔直径(MLD),直径狭窄程度(DS),最小管腔面积(MLA),面积狭窄程度(AS)及病变长度等,并比较相关参数差异性。结果前降支、回旋支及右冠状动脉简单病变的MLD在QCA与IVUS测量比较差异均无统计学意义(t=0.182、0.452、0.207,P>0.05),右冠状动脉合并钙化病变MLD在QCA与IVUS测量比较差异无统计学意义(t=1.489,P>0.05);前降支及右冠状动脉简单病变DS经QCA及IVUS测量结果差异无统计学意义(t=1.441、1.449,P>0.05);回旋支病变DS在QCA小于IVUS测量结果(t=2.496,P<0.05);右冠状动脉合并钙化病变中DS在QCA大于IVUS测量结果(t=2.618,P<0.05)。无论病变类型如何,在测量MLA上,前降支、回旋支及右冠状动脉QCA所测结果小于IVUS所测量结果。结论应用QCA对非钙化、非分叉、非迂曲的简单临界病变在测量MLD及DS一定程度上可以与IVUS所测量的结果媲美,QCA对于这类病变具有较可靠的诊断价值。

Objective To analyze the relevant parameters of intravascular ultrasound(IVUS)and quantitative coronary angiography(QCA)in patients with intermediate non-left main coronary lesions and explore the diagnostic value.Methods A total of 102 patients with intermediate non-left main coronary lesions diagnosed by coronary angiography in the department of cardiology in Huzhou central hospital from September 2017 to December 2019 were selected.The minimum lumen diameter(MLD),diameter stenosis(DS),minimum lumen area(MLA),area stenosis(AS)and stenosis length were assessed by QCA and IVUS,and the differences of related parameters were compared.Results There was no statistically significant difference in the MLD in the simple intermediate lesions of left anterior descending coronary artery,left circumflex coronary artery and right coronary artery between QCA and IVUS measurement(t=0.182,0.452,0.207;P>0.05).There was no statistically significant difference between QCA and IVUS in MLD of right coronary artery with calcification(t=1.489,P>0.05).There was no statistically significant difference in DS of the simple intermediate lesions of left anterior descending coronary artery and right coronary artery between QCA and IVUS measurement(t=1.441,1.449;P>0.05).The DS measured by QCA was less than that measured by IVUS in circumflex branch of left coronary artery(t=2.496,P<0.05).The DS measured by QCA was greater than that measured by IVUS in right coronary artery with calcification(t=2.618,P<0.05).No matter what type the lesion is,the MLAmeasured by QCA was less than that of IVUS in left anterior descending coronary artery,left circumflex coronary artery and right coronary artery.Conclusion MLD and DS of simple intermediate lesions without calcification,bifurcation and tortuosity measured by QCA are comparable to those measured by IVUS to a certain degree,indicating that QCA has reliable diagnostic value for such lesions.