血管内超声技术用于冠心病经皮冠状动脉介入治疗的效果

Application of intravascular ultrasound in percutaneous coronary intervention for coronary heart disease

目的分析血管内超声技术(IVUS)用于冠心病经皮冠状动脉介入(PCI)治疗的效果。方法选取2022年7月至2023年5月河南省第二人民医院收治的86例PCI治疗的冠心病患者为研究对象,根据随机数字表法分为对照组与研究组,每组43例。对照组在冠状动脉造影(CAG)下进行PCI治疗,研究组在IVUS下进行PCI治疗。比较两组支架置入状况(支架数量、球囊支架直径、最大管腔直径、扩张时最大球囊压力、残余狭窄率)、心功能[左室射血分数(LVEF)、左心舒张末期内径(LVEDD)、左心收缩末期内径(LVESD)]、血管及斑块状况[最小血管直径(MID)、斑块负荷(PB)、直径狭窄率(DS)]、不良心血管事件发生率。结果研究组球囊支架直径、最大管腔直径、扩张时最大球囊压力高于对照组,残余狭窄率低于对照组,差异有统计学意义(P<0.05)。手术前后两组LVESD、LVEF、LVEDD水平比较,差异未见统计学意义(P>0.05)。术后3个月,研究组DS、PB低于对照组,MID高于对照组,差异有统计学意义(P<0.05)。研究组不良心血管事件发生率为6.98%(3/43),对照组为37.21%(16/43),差异有统计学意义(P<0.05)。结论IVUS用于冠心病PCI治疗中可获取较大管腔直径,准确指导球囊选择及介入治疗过程,降低残余狭窄率,改善心功能、血管及斑块状况,降低不良心血管事件的发生率。

Objective To analyze the application of intravenous ultrasound(IVUS)in percutaneous coronary intervention(PCI)for coronary heat disease.Methods A total of 86 patients with coronary heart disease who received PCI in the Second People's Hospital of Henan Province from July 2022 to May 2023 were selected and divided into study group and control group according to random number table method,with 43 cases in each group.The control group was given PCI treatment under coronary angiongraphy(CAG),and the study group was given PCI treatment under IVUS.The status of stent implantation(number of stents,diameter of balloon stent,maximal lumen diameter,maximal balloon pressure during dilatation,residual stenosis rate),cardiac function[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)],vessel and plaque status[minimum vessel diameter(MID),plaque burden(PB),diameter stenosis rate(DS)],and adverse cardiovascular events were compared between the two groups.Results Compared with the control group,the balloon stent diameter,the maximum lumen diameter and the maximum balloon pressure during expansion were higher in the study group,and the residual stenosis rate was lower(P<0.05).There were no significant differences in LVESD,LVEF and LVEDD levels between the study group and the control group before and after surgery(P>0.05).Three months after operation,the study group had lower DS,PB and higher MID than the control group(P<0.05).The incidence of adverse cardiovascular events in the study group was 6.98%(3/43),which was lower than that in the control group(37.21%,16/43,P<0.05).Conclusions IVUS can obtain larger lumen diameter in PCI treatment of coronary heart disease,accurately guide balloon selection and interventional treatment process,reduce residual stenosis rate,improve cardiac function,vascular and plate conditions,and reduce the occurrence of adverse cardiovascular events.