血管内超声技术在冠心病经皮冠状动脉介入治疗中的临床应用价值研究

Investigation on the clinical value of intravascular ultrasound in percutaneous coronary intervention for coronary heart disease

目的探讨血管内超声技术在冠心病(CHD)经皮冠状动脉介入治疗中的应用效果。方法50例冠心病患者,随机分为对照组和实验组,各25例。对照组在冠状动脉造影引导下进行经皮冠状动脉介入治疗,实验组在血管内超声技术引导下进行经皮冠状动脉介入治疗。比较两组患者治疗前后心功能指标及血清脑钠肽(BNP)水平、6 min步行距离,手术成功率,术后最大扩张压力、最大管腔直径、最小管腔直径、残余狭窄率,因心绞痛住院、再次手术、心肌梗死、死亡发生率。结果治疗前及治疗后,实验组左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)及血清学BNP水平、6 min步行距离与对照组比较,差异无统计学意义(P>0.05)。实验组和对照组手术成功率均为96.00%(24/25),比较差异无统计学意义(P>0.05)。实验组支架扩张时最大球囊压力(1487.24±200.21)kPa、最大管腔直径(2.30±0.23)mm、最小管腔直径(3.09±0.23)mm均大于对照组的(1335.21±173.35)kPa、(2.01±0.21)mm、(2.67±0.21)mm,术后残余狭窄率(7.67±1.23)%小于对照组的(12.35±2.25)%,差异有统计学意义(P<0.05)。实验组心因心绞痛住院发生率低于对照组,差异有统计学(P<0.05)。结论冠心病患者在血管内超声技术引导下进行经皮冠状动脉介入治疗效果确切,可有效改善心功能指标,且可降低术后残余狭窄率和心绞痛发生率,值得推广。

Objective To discuss the application effect of intravascular ultrasound in percutaneous coronary intervention for coronary heart disease(CHD).Methods A total of 50 patients with coronary heart disease were randomly divided into control group and experimental group,each with 25 cases.The control group underwent percutaneous coronary intervention under the guidance of coronary angiography,and the experimental group underwent percutaneous coronary intervention under the guidance of intravascular ultrasound.Both groups were compared in terms of cardiac function indexes and serum brain natriuretic peptide(BNP)levels,6-min walking distance,surgical success rate,postoperative maximum dilatation pressure,maximum lumen diameter,minimum lumen diameter,and residual stenosis rate before and after treatment,hospitalization for angina pectoris,reoperation,myocardial infarction and mortality.Results Before and after treatment,the differences in left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD)and serum BNP level,6 min walking distance between the two groups were not statistically significant(P>0.05).The success rate of surgery in both the experimental and control groups was 96.00%(24/25),and the difference was not statistically significant(P>0.05).The maximum balloon pressure during stent expansion(1487.24±200.21)kPa,maximum lumen diameter during stent expansion(2.30±0.23)mm,and minimum lumen diameter(3.09±0.23)mm in the experimental group were greater than(1335.21±173.35)kPa,(2.01±0.21)mm,and(2.67±0.21)mm in the control group,and the postoperative residual stenosis rate(7.67±1.23)%was less than(12.35±2.25)%in the control group.All the differences were statistically significant(P<0.05).The hospitalization rate for angina pectoris of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Percutaneous coronary intervention is effective in patients with coronary heart disease under the guidance of intravascular ultrasound,which can improve the cardiac function indicators,reduce the residual stenosis rate and the incidence of angina after surgery,and is worthy of promotion.