摘要
冠状动脉临界病变指的是冠状动脉造影显示冠状动脉的狭窄程度为30%~69%,在临床上临界病变的发生率远高于显著病变,大约为其20倍;另外,部分临界病变是导致急性冠状动脉综合征的罪犯血管,故判断和评估其功能对决策治疗有重要的临床意义。虽然冠状动脉造影仍为诊断冠心病的金标准,然而冠状动脉造影只是对狭窄血管进行解剖性评价,不能对病变处进行病理生理及功能性评价。目前对冠状动脉临界病变的主要检查方法有：负荷超声心动图、多层螺旋CT、CT血管造影确定血流储备分数、放射性核素心肌灌注显像和心脏核磁共振等,这些都为无创性检测手段,冠状动脉血流储备、血流储备分数、光学相干断层扫描技术、血管内超声等有创性检测手段也受到广泛关注。现就冠状动脉临界病变的无创及有创性评价以及治疗做一综述。
The intermediate coronary lesion on angiography is defined as a luminal narrowing with a diameter stenosis of 30% to69%. The incidence of the intermediate stenosis is 20 times than the serious stenosis. Many intermediate coronary lesions develop to acute coronary syndrome,and appears as a dilemma for cardiologists. The degree of stenosis seen on coronary angiography is considered to be the golden standard by which to assess the severity of coronary artery disease. However it can＇t predict functional information of the lesions. Some noninvasive techniques such as SE,MSCT,FFRCT,MPI,CMR and much more,have attracted widespread attention. In the catherteriation laboratory four techniques can be used for the evaluation of the physiologic significance of intermediate or borderline significant coronary stenoses： coronary flow reserve,pressure wire-derived coronary fractional flow reserve,intravascular ultrasound and optimal coherence tomography. This review discusses the assessment and therapy of the intermediate lesions.
出处
《心血管病学进展》
CAS
2016年第2期192-197,共6页
Advances in Cardiovascular Diseases
关键词
无创性检查
血流储备
血流储备分数
血管内超声
光学相干断层扫描技术
Noninvasive techniques
Coronary flow reserve
Fractional flow reserve
Intravascular ultrasound
Optimal coherence tomography
