摘要
目的:探讨痉挛的冠状动脉血管造影(CAG)和血管内超声(IVUS)的病变特征。方法:选择临床上具有心前区不适或疼痛但CAG无显著狭窄的患者进行马来酸麦角新碱试验,根据CAG有无冠状动脉痉挛将患者分为痉挛组及无痉挛组。通过CAG及IVUS探讨痉挛血管的病理特征。IVUS检查包括参考段血管面积(RA)、最小血管内膜腔面积(MLA)、斑块面积(PA)、斑块体积(PV)及斑块的性状和重构指数,斑块的性状分为软斑块和硬斑块(包括纤维斑块、钙化斑块和混合斑块)。结果:成功诱发冠状动脉痉挛20例,痉挛组及无痉挛组患者间性别、吸烟及高脂血症有明显差异(P<0.05),但两组冠状动脉的狭窄程度及斑块的大小无明显差异(P>0.05);痉挛组CAG示轻、中度局限性狭窄伴血管边缘不光滑,IVUS示偏心性纤维斑块,伴血管正性重构。结论:冠状动脉痉挛血管病变常表现为血管边缘不光滑,呈偏心性、稳定性的纤维性斑块,伴血管正性重构。
Objective：To investigate the lesion characteristics of coronary spasm by Intravascular Ultrasound （IVUS）. Methods：Coronary spasm provocation test by iniracoronary administration of ergonovine was perfomed in 42 patients with chest pain at rest and without significant coronary artery stenosis in routine coronary angiography （CAG）. Patients were divided into 2 groups ： spasm group and no-spasm group. The lesion characteristics at the sites of spasm were observed by IVUS and CAG. IVUS was used to measure the reference area （ RA）, minimal luminal areas （MLA）, plaque area（ PA ）, plaque volume （PV）and arterial remodeling index of plaque. The lesions were classified into soft plaque and hard plaque （ including fibrous plaque, calcified plaque and mixed plaque） according to ultrasound patterns of tissue reflection. Results ： Coronary spasm was successfully provoked in 20 patients. Female patients and patients with risk factors of smoking and hypercholesterolemia were more liable to suffer from coronary spasm （ P 〈 0.05 ）, but the severiiy of stenosis and the size of plaque had no significant differences between the two groups（ P 〉 0. 05 ）. IVUS showed local eccentric high-echo intensity fibrous plaque and positive remodeling in spasm group. Conclusion ： The lesion at the site with local spasm often manifests roughness and stable fibrous proliferation and positive vessel remodeling.
出处
《华北国防医药》
2007年第1期53-56,共4页
Medical Journal of Beijing Military Region
