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目的: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用价值。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(IVUS)检查冠状动脉临界病变的价值。结果:与CAG检查比较,IVUS检查的冠状动脉平均直径狭窄率均显著升高[左主干:(65.3l±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(75.3l±7.81)%,P均<0.01]。CAG和IVUS检查在斑块钙化及斑块破裂的检出率方面无显著差异(P>0.05)。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。
Objective: To investigate the value of intravascular ultrasound (IVUS) in the diagnosis of left anterior descending coronary artery and the critical lesion of left main coronary artery. Methods: The critical coronary arteries (including 20 cases with left main trunk, 20 cases with proximal anterior descending artery and 20 cases with middle part of anterior descending artery) diagnosed by coronary angiography (CAG) Check the value of coronary critical disease. Results: Compared with CAG, the average diameter of coronary artery stenosis in IVUS was significantly higher than that in CUS (left main trunk: (65.31 ± 7.81)% vs (75.28 ± 8.89)%), proximal anterior descending artery (66.67 ± 8.79) % (78.89 ± 7.88)%, middle part of anterior descending branch: (71.55 ± 6.83)% (75.31 ± 7.81)%, P <0.01 respectively). There was no significant difference in the detection rate of plaque calcification and plaque rupture between CAG and IVUS (P> 0.05). CONCLUSIONS: CAG underestimates coronary artery stenosis to varying degrees, especially proximal segment of anterior descending artery. IVUS can effectively supplement CAG and increase the detection rate of unstable plaque, which makes up for the deficiency of CAG.