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目的:应用血管内超声(IVUS)对冠状动脉(冠脉)弥漫性斑块患者进行检查,比较IVUS与冠脉造影(CAG)对冠脉弥漫性斑块的诊断价值。方法:对经CAG发现冠脉弥漫性狭窄或可疑的39例患者(39支冠脉血管,其中左前降支16例,左回旋支12例,右冠脉11例)同时进行IVUS检查,对照这2种检查结果进行比较。结果:CAG显示的病变血管狭窄程度(面积狭窄率)及斑块累及长度明显低于IVUS所示的结果,而IVUS显示斑块累及范围明显大于CAG结果[(39.48±9.33)mm∶(30.26±8.57)mm],在弥漫性斑块累及冠脉的狭窄率上IVUS高于CAG[(67.2±8.1)%∶(60.3±7.3)%],二者差异具有统计学意义(P<0.05)。CAG无法显示冠脉内形态及斑块性状,而通过IVUS可以清晰显示斑块的形态与性状。结论:对于冠脉内弥漫性斑块,CAG低估了病变程度,IVUS可以直接看到冠脉的横截面,从而明确冠脉狭窄的性状和严重程度,相对于CAG来说,IVUS是评价弥漫性斑块的一种精确方式。
Objective: To evaluate the diagnostic value of IVUS and coronary angiography (CAG) in patients with diffuse plaque in coronary artery by intravascular ultrasound (IVUS). Methods: Thirty-nine patients (39 coronary vessels, including 16 cases of left anterior descending coronary artery, 12 cases of left circumflex artery and 11 cases of right coronary artery) were examined by CAG at the same time with IVUS. 2 kinds of test results to compare. Results: The degree of stenosis (area stenosis rate) and plaque length in CAG were significantly lower than those in IVUS, while the extent of plaque in IVUS was significantly greater than that in CAG [(39.48 ± 9.33) mm:(30.26 ± (67.2 ± 8.1)% (60.3 ± 7.3)%]. The difference between the two groups was statistically significant (P <0.05). CAG can not display coronary intracortical and plaque characteristics, and IVUS can clearly show the plaque morphology and traits. CONCLUSIONS: CAG underestimates the extent of disease in diffuse plaques within the coronary arteries. The cross-section of the coronary arteries can be directly visualized by IVUS to characterize the severity and severity of coronary stenosis. IVUS is a measure of diffuseness relative to CAG A precise way of plaque.