血管内超声结合压力导丝对冠状动脉临界病变的判断价值
罗丹;陈勤芬;鞠祥;谢学玲;李拥军;汤成春;马根山;冯毅;戴启明;童嘉毅;王润民;章晓国
【期刊名称】《江苏医药》 【年(卷),期】2012(038)016
【摘要】Objective To investigate the value of intravascular ultrasound combined with pressure wire in evaluating intermediate artery stenosis. Methods Fourty-two patients had 56 lesions of intermediate coronary lesions (40% to 70% stenosis) diagnosed by coronary artery angiography (CAG). Myocardial fractional flow reserve (FFR) was determined by pressure wire, and minimal lumen area (MLA) and area stenosis rate at the lesion region were determined by intravascular ultrasound(IVUS). Optimal IVUS criteria for functionally significant stenoses (FFR <0. 75) were assessed through receiver operating characteristic (ROC) curve analysis. Results The area stenosis rate was (75. 0+3. 8)% ,MLA was (3. 83+0. 37) mm2 ,FFR was 0. 78+0. 03,and FFR<0. 75 in 29 lesions. All lesions were significantly lower than those in control group with normal artery (FFR = 0.95 ±0.03). Area stenosis rate showed a significant negative correlation with FFR (r=-0. 72, F<0. 01). MLA had a significant positive correlation with FFR (r=0. 60, P<0. 01). By ROC analysis, IVUS area stonosis rate > 75% (sensitivity 91%, specificity 76%), MLA < 3. 0 mm2 (sensitivity 87%,specificity 64%) were confirmed the optimal cut-off values consistent with FFR< 0. 75. Conclusion IVUS
parameters (area stonosis rate and MLA) are closely correlated to FFR< 0. 75,which may be used to determine the functional significance of the lesions in patients with intermediate coronary artery stenosis.%目的 探讨血管内超声(IVUS)指标结合压力导丝评价冠状动脉临界病变的价值.方法 42例患者冠状动脉造影(CAG)显示临界病变(直径狭窄率40％-70％)56处,用压力导丝测定其心肌血流储备分数(FFR),IVUS测定最小管腔面积(MLA)、血管外膜面积计算面积狭窄率.以FFR＜0.75为界值,采用受试者工作特征曲线(ROC)选择IVUS指标的切点.结果 56处血管病变的IVUS测得面积狭窄率为(75.0±3.8)％,MLA(3.83±0.37) mm2.压力导丝测得FFR为0.78±0.03,29处病变低于界限值(FFR＜0.75),均显著低于CAG正常对照组(FFR为0.95±0.03).IVUS面积狭窄率与FFR呈负相关(r=-0.72,P＜0.01).以FFR＜0.75为界值,根据ROC分析,面积狭窄率≥75％、MLA≤3.0mm2为切点灵敏性分别为94％、85％,特异性73％、66％.结论 IVUS测定的面积狭窄率≥75％和MLA≤3.0 mm2与FFR＜0.75密切相关,可据此判断临界病变的血管功能,指导临床处理策略的制定. 【总页数】3页(1902-1904)
【关键词】冠状动脉疾病;血管内超声显像;心肌血流储备分数
【作者】罗丹;陈勤芬;鞠祥;谢学玲;李拥军;汤成春;马根山;冯毅;戴启明;童嘉毅;王润民;章晓国
【作者单位】210009 江苏省,东南大学附属中大医院心脏病科;210009 江苏省,东南大学附属中大医院心脏病科;210009 江苏省,东南大学附属中大医院心脏病科;210009 江苏省,东南大学附属中大医院心脏病科;210009 江苏省,东南大学附
属中大医院心脏病科;210009 江苏省,东南大学附属中大医院心脏病科;210009 江苏省,东南大学附属中大医院心脏病科;210009 江苏省,东南大学附属中大医院心脏病科;210009 江苏省,东南大学附属中大医院心脏病科;210009 江苏省,东南大学附属中大医院心脏病科;210009 江苏省,东南大学附属中大医院心脏病科;210009 江苏省,东南大学附属中大医院心脏病科 【正文语种】中文 【中图分类】R541 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_jiangsu-medical-journal_thesis/0201249054133.html 【相关文献】
1.血管内超声显像指标对冠状动脉中度狭窄病变功能意义的判断价值 [J], 程训民; 何国祥; 仝识非; 冉擘力; 刘建平; 姚青; 宋治远
2.血管内超声在介入治疗冠状动脉临界病变中的价值 [J], 李俊峡; 赵玉英; 李树仁; 张莉; 丁超; 齐晓勇
3.血管内超声在基层医院介入治疗冠状动脉临界病变中的应用价值 [J], 陆荣荣; 木合塔尔·吾布力
4.急性冠状动脉综合征参考段血管病变对血管内超声评估冠状动脉重构的影响 [J], 宋达琳; 康维强
5.冠状动脉分叉病变支架跨越分支技术对分支血管的影响及机制——血管内超声和冠状动脉造影对照研究 [J], 李丽; 盖鲁粤; 杨庭树; 王禹; 刘宏斌; 陈练; 孙志军
血管内超声结合压力导丝对冠状动脉临界病变的判断价值
