【摘要】 目的评估血管内超声(IVUS)指导单支架术式处理左主干分叉病变患者的安全性和有效性。方法选择2017年1月至2019年1月焦作市人民医院收治的146例冠状动脉造影确诊为左主干末端真性分叉病变患者作为观察对象,经血管内超声评估对做回旋支斑块负荷≤56%或开口管腔面积≥3. 7 mm2的患者采取单支架术式处理,观察患者治疗后不良心血管事件的发生率。结果 IVUS检查提示,术前回旋支开口负性重构指数为(0. 9±0. 2),其中89例发生负性重构。术后左主干、前降支开口的最小管腔直径、管腔面积、斑块负荷与术前比较,差异有统计学意义(P <0. 05);术后回旋支开口除最小管腔直径与术前比较,差异未见统计学意义(P>0. 05),管腔面积、斑块负荷与术前比较,差异有统计学意义(P <0. 05)。外弹力膜偏心指数与术前比较,差异有统计学意义(P <0. 05)。结论血管内超声指导下的单支架术式处理左主干分叉病变患者是安全可行的。更多还原

【Abstract】 Objective To evaluate the safety and effectiveness of intravascular ultrasound( IVUS) in the treatment of patients with left main bifurcated lesions. Methods From January 2017 to January 2019,146 patients with true bifurcation at the end of left main artery diagnosed by coronary angiography were selected as the observation objects. The patients with plaque load ≤ 56% or open lumen area ≥ 3. 7 mm~2 were treated with single stent by intravascular ultrasound evaluation to observe the incidence of adverse cardiovascular events after treatment. Results IVUS examination showed that the negative reconstruction index of the opening of the circumflex branch was( 0. 9 ± 0. 2),89 cases of which had negative reconstruction. There were significant differences in the minimum lumen diameter,lumen area and plaque load of the left main trunk and anterior descending branch after operation compared with those before operation( P < 0. 05); there was no significant difference in the minimum lumen diameter of the circumflex branch after operation compared with that before operation( P > 0. 05),and there were significant differences in lumen area and plaque load compared with that before operation( P < 0. 05).The eccentric index of external elastic membrane was significantly different from that before operation( P <0. 05). Conclusion Under the guidance of intravascular ultrasound,single stent is safe and feasible in the treatment of patients with left main bifurcation disease.更多还原