| 尹卫华,李响楠,田涛,吕滨.钙化斑块特征分析预测冠状动脉支架植入术中是否旋磨[J].中国医学影像技术,2020,36(2): |
| 钙化斑块特征分析预测冠状动脉支架植入术中是否旋磨 |
| Analysis of the 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：2020-02-16 |
| DOI： |
| 中文关键词: 冠状动脉 钙化 旋磨术 |
| 英文关键词:coronary calcification rotational atherectomy |
| 基金项目:国家重点研发计划（2016YFC1300403）及中央高校基本科研业务费专项基金资助（3332018063） |
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| 中文摘要: |
| 目的 通过分析钙化斑块的特征来预测冠状动脉支架（Percutaneous coronary intervention，PCI）术中是否需要旋磨。方法 回顾性分析2016年12月至2018年12月来我院就诊的157名有症状的疑诊冠心病患者，患者先后行冠状动脉CT血管成像（Coronary CT angiography, CCTA）、冠状动脉造影及血管内超声检查（Intravascular ultrasound, IVUS）。157名患者（224个靶血管病变）均成功实施PCI。通过CT、造影及IVUS定量分析来预测PCI术中是否需要旋磨。结果 133名患者（196个靶血管病变）没有旋磨，24名患者（28个病变）PCI术中实施旋磨。术中旋磨的患者与未旋磨的患者相比，具有更高的SYNTAX积分（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）。病变处的钙化积分≥313、管腔的狭窄率≥75%以及钙化弧度≥270°预测患者需要旋磨。当校正了所有的混杂因素后，病变处钙化积分（OR值1.03, 95%可信区间1.015-1.053，p＜0.001）及钙化弧度≥270°（OR值1.17, 95%可信区间1.025-1.231，p<0.001）是患者需要旋磨的独立预测因子。结论 冠状动脉CT作为一项无创的影像学技术，反映靶病变钙化程度的钙化积分及弧度分级是预测钙化病变旋磨的独立预测因子。 |
| 英文摘要: |
| Objective To analysis the characteristic of calcified plaque to predict the requriement for rotation during percutaneous coronary intervention (PCI). Methods Patients with symptoms suspicious of coronary artery disease underwent coronary CT angiography (CCTA), invasive coronary angiography (ICA) and intravascular ultrasound (IVUS) within three month, were retrospectively included from December 2016 to December 2018. In 157 consecutive subjects (224 target leisions) underwent successful PCI. CCTA, ICA and IVUS were retrospectively evaluated regarding their ability to predict rotablation. Results 133 patients (196 target leisions) did not performed rotablation during PCI, and rotablation was added in 24 patients (28 target leisions). Patients with rotablation had significantly higher SYNTAX score (P=0.02) and per-vessel, per-leision calcium Agatston score (P<0.01) than those without rotablation. Per-leision calcium score≥313, diameter stenosis ≥75%, and calcification arc ≥270 predict rotablation. After adjustment for potential confounding factors, per-leision calcium score (odd ratio 1.03, 95% confidence interval 1.015-1.053, p＜0.001) and calcification arc ≥270 (odd ratio 1.17, 95% confidence interval 1.025-1.231, p<0.001) were independent predictor of rotablation. Conclusion As a non-invasive technique, CT per-leision calcium score and calcification arc ≥270 were independent predictor of rotablation during PCI. |
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