血管内超声指导下经皮冠状动脉介入术治疗复杂冠状动脉病变患者的效果

Effects of intravascular ultrasound guided-PCI in treatment of patients with complex coronary artery disease

目的:观察血管内超声指导下经皮冠状动脉介入术(PCI)治疗复杂冠状动脉(冠脉)病变患者的效果。方法:选取2020年1月至2023年2月该院收治的90例复杂冠脉病变患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各45例。对照组采用常规PCI治疗,研究组采用血管内超声指导下PCI治疗,比较两组手术前后心功能指标[左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)和左心室射血分数(LVEF)]水平、血管内皮功能指标[内皮素-1(ET-1)、同型半胱氨酸(Hcy)]水平、随访3个月的心血管不良事件发生率、手术成功率和随访3个月的冠脉再狭窄率。结果:术后,研究组LVEF水平高于对照组,LVESD和LVEDD水平均低于对照组,差异有统计学意义(P<0.05);研究组ET-1、Hcy水平均低于对照组,差异有统计学意义(P<0.05);研究组心血管不良事件发生率为8.89%(4/45),低于对照组的24.44%(11/45),差异有统计学意义(P<0.05);研究组手术成功率高于对照组,冠脉再狭窄率低于对照组,差异均有统计学意义(P<0.05)。结论:血管内超声指导下PCI治疗复杂冠脉病变患者可提高手术成功率,改善心功能指标水平,降低血管内皮功能指标水平、心血管不良事件发生率和冠脉再狭窄率,效果优于常规PCI治疗。

Objective:To observe effects of intravascular ultrasound guided-percutaneous coronary intervention(PCI)in treatment of patients with complex coronary artery disease.Methods:A prospective study was conducted on 90 patients with complex coronary artery disease admitted to this hospital from January 2020 to February 2023.They were divided into control group and observation group according to the random number table method,45 cases in each.The control group was treated with conventional PCI,while the study group was treated with intravascular ultrasound guided-PCI.The levels of cardiac function indexes[left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)]and the vascular endothelial function indexes[endothelin-1(ET-1),homocysteine(Hcy)],the incidence of cardiovascular adverse events at 3 months of follow-up,the success rate of the surgery,and the coronary restenosis rate at 3 months of follow-up were compared between the two groups.Results:After the surgery,the level of LVEF in the study group was higher than that in the control group,the levels of LVESD and LVEDD were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of ET-1 and Hcy in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of cardiovascular adverse events in the study group was 8.89%(4/45),which was lower than 24.44%(11/45)in the control group,and the difference was statistically significant(P<0.05).The success rate of the surgery in the study group was higher than that in the control group,the coronary restenosis rate was lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusions:Intravascular ultrasound-guided PCI for the patients with complex coronary artery lesions can improve the success rate of surgery,improve the levels of cardiac function indicators,and reduce the levels of vascular endothelial function indexes,the incidence of cardiovascular adverse events and the coronary restenosis rate.Moreover,it is superior to single conventional PCI treatment.