血管内超声指导经皮冠状动脉介入治疗对非ST段抬高型急性冠状动脉综合征临界病变患者的影响

Effect of percutaneous coronary intervention guided by intravascular ultrasound in treatment of patients with borderline lesions of non-ST elevated acute coronary syndrome

目的探讨血管内超声(IVUS)指导经皮冠状动脉介入治疗(PCI)对非ST段抬高型急性冠状动脉综合征(NSTE-ACS)临界病变患者血浆脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)及主要不良心血管事件(MACE)的影响。方法回顾性分析65例行PCI的NSTE-ACS临界病变患者的临床资料,根据PCI指导方式分为IVUS组33例和血流储备分数(FFR)组32例。比较2组PCI情况及手术前后血浆BNP、hs-CRP水平的变化。术后随访12个月,比较2组患者MACE发生情况。结果入院即刻,2组患者的血浆BNP、hs-CRP水平比较,差异无统计学意义(P>0.05);术后7 d,2组患者的血浆BNP、hs-CRP水平均低于入院即刻,且IVUS组低于FFR组,差异有统计学意义(P<0.05)。2组患者MACE、复发性心绞痛发生情况比较,差异无统计学意义(P>0.05)。结论IVUS指导PCI治疗NSTE-ACS临界病变患者可改善BNP、hs-CRP水平,且不会增高MACE发生风险。

Objective To investigate the effects of percutaneous coronary intervention(PCI)guided by intravascular ultrasound(IVUS)on plasma brain natriuretic peptide(BNP),high sensitivity C reactive protein(hs-CRP)and major adverse cardiovascular events(MACE)in patients with borderline lesions of non-ST segment elevated acute coronary syndrome(NSTE-ACS).Methods Clinical materials of 65 patients with borderline lesions of NSTE-ACS by PCI were analyzed retrospectively,and they were divided into IVUS group(n=33)and fractional flow reserve(FFR)group(n=32)according to PCI guidance.The PCI status and the change of plasma BNP and hs-CRP levels before and after the operation were compared.The patients were followed up for 12 months,and the incidence of MACE was compared between the two groups.Results At the moment of admission,there were no significant differences in plasma BNP and hs-CRP levels between the two groups(P>0.05).On the 7 th day after operation,the plasma levels of BNP and hs-CRP in both groups were significantly lower than those at the moment of admission,and those indexes in the IVUS group were significantly lower than the FFR group(P<0.05).There were no significant differences in MACE and recurrent angina between the two groups(P>0.05).Conclusion PCI guided by IVUS can improve the levels of BNP and hs-CRP in patients with borderline lesions of NSTE-ACS and will not increase the occurrence risk of MACE.