【摘要】 目的 :确定血管内超声能否定量评价冠状动脉重构 ,粥样硬化冠状动脉重构是否呈偏心性 ,以及重构在超声图像上的特点及其影响因素。方法 :用 30 MHz单晶片超声探头检查了 11例冠心病患者的冠状动脉。在血管内超声图像上 ,测算了 34个血管切面舒张末期的有关参数 (n=34 )。包括 :管腔环形因子 (CSF- L ) ,内膜外边缘环形因子 (CSF- I) ,和中层外边缘环形因子 (CSF- M)等。结果 :CSF- L (0 .91± 0 .0 6 ) <CSF- I (0 .94± 0 .0 4) ,CSF-I<CSF- M (0 .95± 0 .0 4) ;CSF- L和 CSF- I的差别有显著性 (P<0 .0 1)。分别有 5 0 % (17/ 34 )、 47.1% (16 / 34 )、和2 3.5 % (8/ 34 )的 CSF- L、CSF- I、和 CSF- M<0 .92。多因素分析显示脂质是 CSF- L 的独立影响因素 (复合 R=0 .42 ) ,CSF- L和 L IA (管腔 +内膜面积 )是 CSF- I的独立影响因素 (复合 R=0 .6 0 ) ,CSF- I是 CSF- M的独立影响因素 (复合 R=0 .5 7)。结论 :粥样硬化冠状动脉重构可以是偏心性的 ;粥样硬化虽然可向管腔和管壁两个方向发展 ,但更易于向管腔方向 ;偏心性重构从内向外逐渐减轻 ;内膜偏心性重构影响中层偏心性重构 ;粥样硬化病变成分可能影响偏心性重构。更多还原

【Abstract】 Objective:To determine whether wall remodeling of coronary arteries be quantitatively evaluated by IVUS,whether wall remodeling of atherosclerotic coronary arteries be eccentric,and what were ultrasonic remodeling characterics and their morphologic influencing factors.Methods:Eleven patients with coronary artery disease were examined using a single-element 30MHz ultrasound transducer.The parameters of 34 cross sections(n=34)were measured or calculated at end-diastole with IVUS,which included lumen circular shape factor(CSF-L),circular shape factor of external border of the intima(CSF-I),circular shape factor of external border of the media(CSF-M),etc.Results:CSF-L(0.91±0.06)was smaller than CSF-I(0.94±0.04),and CSF-I smaller than CSF-M(0.95±0.04).The difference between CSF-L and CSF-I was significant(P<0.01).50%(17/34)of CSF-L,47.1%(16/34)of CSF-I,and 23.5%(8/34)of CSF-M were<0.92.Multivariate analysis revealed that lipid component was the independent predictor of CSF-L(multiple R=0.42),CSF-L and LI A(lumen+intima area),the independent peredictors of CSF-I(multiple R=60),and CSF-I,the independent predictor of CSF-M(multiple R=0.57).Conclusions:These data suggest that wall remodeling of atherosclerotic coronary arteries be eccentric,and atherosclerotic lesions develop toward both luminal and intramural directions,but more easily toward luminal direction.Eccentric wall remodeling reduces from inner to external.Eccentric intimal remodeling affects eccentric medial remodeling.And the components of atherosclerotic lesions may affect eccentric wall remodeling.更多还原