血管内超声与冠状动脉造影指导的经皮冠状动脉介入治疗左主干病变的研究机制

Mechanism of Percutaneous Coronary Intervention Guided by Intravascular Ultrasound and Coronary Angiography for Left Main Artery Disease

目的探讨血管内超声与冠状动脉造影指导的经皮冠状动脉介入治疗左主干病变的效果。方法回顾性分析220例左主干病变患者的临床资料,全部患者均行左主干支架置入术治疗,超声组使用血管内超声引导(n=80),造影组应用冠状动脉造影引导(n=140),对两组治疗预后进行比较。结果相较于造影组,超声组治疗后取得了更高的球囊对吻扩张率、后扩张率、双支架术应用率以及操作成功率(P<0.05);相较于造影组,超声组治疗后取得了更低的心肌梗死、再次血运重建率(P<0.05);两组靶血管血运重建率与靶病变血运重建率差异无统计学意义(P>0.05)。结论在对左主干病变进行治疗时,相较于冠状动脉造影,血管内超声指导下经皮冠状动脉介入治疗可取得更好的效果,具备更高的安全性。

Objective To investigate the effect of percutaneous coronary intervention guided by intravascular ultrasound and coronary angiography in the treatment of left main artery lesions.Methods The clinical data of 220 patients with left main disease were retrospectively analyzed.All patients were treated with left main stent implantation.Intravascular ultrasound guidance was used in the ultrasound group(n=80),and coronary angiography guidance was used in the angiography group(n=140).Results Compared with contrast group,ultrasound group achieved higher balloon contralateral expansion rate,posterior expansion rate,double stenting application rate and operation success rate after treatment(P<0.05).Compared with contrast group,ultrasound group achieved lower rate of myocardial infarction and revascularization after treatment(P<0.05).There was no significant difference between the target vessel revascularization rate and the target lesion revascularization rate between the two groups(P>0.05).Conclusion In the treatment of left main disease,compared with coronary angiography,intravascular ultrasound guided percutaneous coronary intervention can achieve better results and has higher safety.