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目的报告应用血管内超声(IVUS)评估冠心病患者冠状动脉重构及斑块稳定性诊疗的体会。方法使用血管内超声观察236例冠心病患者(经冠状动脉造影确诊),其中不稳定型心绞痛(UA)78例,稳定型心绞痛(SA)61例,急性心肌梗死(AMI)97例。结果SA组以稳定的纤维斑块为主,UA和AMI组以不稳定的软斑为主;UA和AMI组的偏心指数明显高于SA组(P<0.05)。UA组和AMI组以正性重构为主。结论IVUS能更准确观察冠状动脉内粥样斑块的特点,观察冠状动脉管腔的形态及狭窄的严重程度,对冠心病诊断具有独特的临床价值。
Objective To report the application of intravascular ultrasound (IVUS) in the diagnosis of coronary artery remodeling and plaque stability in patients with coronary heart disease. Methods Totally 236 patients with coronary heart disease (confirmed by coronary angiography) were diagnosed by intravascular ultrasound, including 78 cases of unstable angina pectoris (UA), 61 cases of stable angina pectoris (SA) and 97 cases of acute myocardial infarction (AMI). Results The stable fibrous plaque was the main factor in SA group. The unstable plaque was the main factor in UA and AMI groups. The eccentric index in UA and AMI groups was significantly higher than that in SA group (P <0.05). UA group and AMI group mainly positive reconstruction. Conclusion IVUS can more accurately observe the characteristics of atherosclerotic plaque in coronary artery, and observe the morphology of coronary artery and the severity of stenosis. IVUS has unique clinical value in the diagnosis of coronary heart disease.