| 尹卫华,李响楠,田涛,吕滨.钙化斑块特征预测经皮冠状动脉介入治疗术中旋磨[J].中国医学影像技术,2020,36(2):165~170 |
| 钙化斑块特征预测经皮冠状动脉介入治疗术中旋磨 |
| Characteristic of calcified plaque for predicting the addition of rotational atherectomy during percutaneous coronary intervention |
| 投稿时间：2019-05-31 修订日期：2019-09-12 |
| DOI：10.13929/j.issn.1003-3289.2020.02.002 |
| 中文关键词: 冠状动脉疾病 钙质沉着症 旋磨术 |
| 英文关键词:coronary disease calcinosis rotational atherectomy |
| 基金项目:国家重点研发计划项目（2016YFC1300403）、中央高校基本科研业务费专项基金（3332018063）。 |
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| 中文摘要: |
| 目的 探讨钙化斑块特征预测经皮冠状动脉介入治疗（PCI）术中是否需要旋磨的可行性。方法 对157例有症状并先后接受冠状动脉CT血管成像（CCTA）、冠状动脉造影及血管内超声检查（IVUS）的疑诊冠心病患者（224个靶血管病变）均成功实施PCI，观察钙化斑块特征可否预测PCI术中旋磨。结果 24例（28个靶血管病变）PCI术中实施旋磨，133例（196个靶血管病变）未旋磨，前者SYNTAX积分更高（P=0.02），且在血管水平及病变水平上具有更高的Agatston钙化积分（P<0.01）。病变处钙化积分≥313、管腔狭窄率≥75%及钙化弧度≥270°提示需要旋磨。校正后，病变处钙化积分[OR=1.03，95%CI（1.015，1.053），P<0.001）及钙化弧度≥270°[OR=1.17，95%CI（1.025，1.231），P<0.001）是需要旋磨的独立预测因子。结论 CT所示钙化积分及弧度分级是对钙化病变进行旋磨的独立预测因子。 |
| 英文摘要: |
| Objective To observe the characteristics of calcified plaque for predicting the requirement for rotation during percutaneous coronary intervention (PCI). Methods Data of 157 patients with symptoms suspicious of coronary artery disease who underwent coronary CT angiography (CCTA), invasive coronary angiography (ICA) and intravascular ultrasound (IVUS) were retrospectively analyzed. PCI was successfully performed in all 157 subjects (224 target lesions). CCTA, ICA and IVUS were retrospectively evaluated regarding the ability to predict rotablation. Results Rotablation was added in 24 patients (28 target lesions) during PCI, whereas in 133 patients (196 target lesions) did not. Patients with rotablation had significantly higher SYNTAX score (P=0.02) and per-vessel, per-lesion calcium Agatston score (P<0.01) than those without rotablation. Per-lesion calcium score ≥ 313, diameter stenosis ≥ 75% and calcification arc ≥ 270 predicted rotablation. After adjustment for potential confounding factors, per-lesion calcium score (odd ratio 1.03, 95%CI[1.025,1.231], P<0.001) and calcification arc ≥ 270 (odd ratio 1.17, 95%CI, P<0.001) were independent predictors of rotablation. Conclusion CT per-lesion calcium score and calcification arc ≥ 270 were independent predictors of rotablation during PCI. |
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