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目的：探讨血管内超声( IVUS)指导下介入治疗前降支( LAD)病变的疗效。方法选取2015年11月至2016年7月收治的LAD近段或中段接受经皮冠状动脉介入( PCI)治疗的冠心病患者28例。比较利用冠状动脉造影指导下判定的拟置入支架的参数和应用IVUS指导下判定的拟置入支架的参数。以IVUS获得的参数作为最终置入支架参数。结果造影指导下预判支架长度为(30.5±11.6)mm,IVUS指导下预判支架长度为(29.2±11.4)mm,两者比较,差异无统计学意义(P>0.05)。造影指导下预判支架直径为(2.93±0.36)mm,IVUS指导下预判支架直径为(3.14±0.39)mm,两者比较,差异有统计学意义(P0.05)；造影指导下预判支架直径为(2.91±0.35)mm,IVUS指导下预判支架直径为(3.13±0.40)mm,两者比较,差异有统计学意义(P0. 05). The stent diameter from IVUS was (3. 14 ± 0. 39) mm, which was different with it from angiography (2. 93 ± 0. 36) mm (P0. 05). The stent diameter from IVUS was (3. 13 ± 0. 40) mm, which was different with it from angiography (2. 91 ± 0. 35) mm (P<0. 05). Conclusion To perform LAD interventional therapy guided by IVUS,the stent diameter is greater than the application of imaging guidance. There is no statistical significant to get the stent length. The relatively normal vessel segment is different from angiography and IVUS in some rare settings in few cases.