应用血管内超声评价冠状动脉狭窄部位的重构

The Use of Intravascular Ultrasound in Evaluating Coronary Remodeling of Stenotic Atherosclerotic Plaques

目的 :应用血管内超声评价冠状动脉狭窄部位的重构。方法 :24支近段和远段均有病变的冠状动脉 ,共有病变48处 ,用血管内超声测量病变部位和近、远端参考部位的管腔面积 (LA)和血管面积 (VA) ,并计算血管面积比 (病变部位VA/近、远端参考部位VA的平均值 ) ,评价病变部位的重构类型。结果 :近段和远段病变的局部面积狭窄率和管腔面积狭窄率无显著性差异 ,而近段的血管面积比大于远段 (P<0.01) ,远段病变负性重构多于近段病变。结论 :在狭窄程度相同的情况下 。

To evaluate coronary remodeling of stenotic atherosclerotic plaques by intravascular ultrasound. Methods:Forty_eight coronary artery lesions in 24 coronary arteries located in proximal and distal areas of each coronary artery were imaged by intravascular ultrasound(IVUS).The vessel areas(VA)within the external elastic lamina and the lumen area(LA) were measured at lesion site,and the proximal and distal referencesites.The VA ratio was defined as lesion VA/average of the proximal and distal reference VA to represent the degree of vessel remodeling.Results:VA ratio at the lesion site was significantly higher in proximal segments than that in distal segments(1.22±0.32 vs 1.03±0.30,P<0.01).The distal coronary segments showed negative remodeling more often than proximal segments(16.7% vs 8.3%,P<0.01).Conclusion:Proximal coronary segments showed more prominent compensatory enlargement than distal segments under the condition of similar degree of luminal narrowings.