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1、血管内超声诊断冠状动脉临界病变的临床研究【摘要】「【的：探讨血管内超声(IVUS)诊断左冠脉前降支及左主干冠状动脉临界病变的应川价值。方法：以60例冠状动脉造影(CAG)诊断的冠状动脉临界病变(包括20例左主干病例，前降支近段20例，前降支中段20例)为标准，分析血管内超声(1VUS)检杏冠状动脉临界病变的价值。结果：与CAG检杳比较，1VUS检查的冠状动脉平均直径狭窄率均显著升高[左主干:(65.引±7.81)%比(75.28±8.89)%,前降支近段：(66.67±8.79)%比(78.89±7.88)%,前降支中段：(71.55±6.83)%比(75.31±7.81
2、)%,P均vO.Ol]。CAG和IVUS检查在斑块钙化及斑块破裂的检出率方而无显著差异(P>0.05)o结论：CAG不同程度地低估了冠状动脉狭窄，尤其是前降支近段，IVUS可对CAG作有效的补充，并且提高不稳定斑块的检出率，弥补了CAG的不足。【关键词】超声心动描记术;冠状动脉疾病;冠状血管造影术ValuediagnosingcoronaryborderlinelesionbyintravascularultrasoundimagingCAIHeng-zhi,YUHuai,ZHANGYu-lin,SUNMeng,YUBo//DepartmentofCardiology,S
3、econdAffiliatedHospitalofHcirbinMedicalUniversity,Harbin,Heilongjiang,150001,ChinaAbstract：Objective：Toevaluatevalueofapplicationofintravascularultrasoundimaging(IVUS)indiagnosingborderlinelesionsinleftanteriordescendingartery(LAD)andleftmaincoronaryartery(LM).Methods：Accordingtoresultsof
4、coronaryangiography(CAG)in60caseswithcoronaryborderlinelesions,including20casesinLM,20casesinproximalsegmentofLADand20casesinmiddlesegmentofLAD,thediagnosticvalueofIVUSincoronaryborderlinelesionwasevaluated.Results：ComparedwithCAG,meandiameterstenosisrateofeachcoronaryartery[LM：(65.引土7.81
5、)%vs.(75.28+8.89)%,proximalsegmentofLAD：(66.67±8.79)%vs.(78.89±7.88)%,middlesegmentofLAD：(71.55±6.83)%vs.(75.31±7.81)%,P<0.01all]significantlyincreasedinIVUS.ThedifferencesofdetectionrateofplaquecalcificationandplaquerupturewerenosignificantbetweenCAGandIVUS(P>().()5).Conclusion：Different
6、degreesofunderestimationofcoronaryarterystenosisexistinCAG,especiallyinproximalsegmentofLAD.IVUScanbeaneffectivecomplementtoCAG.Keywords：Echocardiography;Coronaryarterydisease;CoronaryangiographyCoronaryheartdisease(CHD)isprimarycausefordeathofadultpatientswithheartdiseaseinChina,anditsin
7、cidencerateandmortalityrateareincreasingyearbyyear.Thus,correctdiagnosisofCHDisveryimportantforactivetreatmentandimprovementofprognosisfl].Thoughcoronaiyangiography(CAG)isregardas"goldstandardM,butitbelongstotwo-dimensionalplanemeasurementandcanonlyobserveinnerappea
