冠状动脉钙化病变识别与评估进展

Progress in the recognition and evaluation of coronary artery calcification

关键词:  冠状动脉钙化  冠状动脉计算机断层扫描  冠状动脉造影  冠状动脉血管内超声  光学相干成像

Key words:  coronarycalcified lesions  computed tomography (CTA)  coronary angiography (CAG)  intravascular ultrasound (IVUS)  optical coherence tomography (OCT)

摘要:

冠状动脉钙化（CAC）在很多复杂性冠状动脉病变中都有所涉及，使得经皮冠状动脉介入治疗（PCI）难度大大增加，给心脏介入临床带来了很大的挑战。而预先准确评估冠状动脉的钙化病变对于后续治疗有着至关重要的影响。近年来，随着医学领域对冠状动脉钙化病变研究的不断深入，在临床中可以通过许多其他针对冠脉的检查，来帮助完成对钙化病变的预先评估，从而规避了介入治疗的风险，改善了介入治疗的预后。本文分别从冠状动脉计算机断层扫描（computed tomography angiography，CTA）、冠状动脉造影（coronary angiography，CAG）、冠状动脉血管内超声（intravascular ultrasound，IVUS）及光学相干成像（optical coherence tomography，OCT）4种临床常用辅助检查的角度，详细分析各种技术手段所存在优势与不足，并强调在实际临床工作中，我们需要将无创手段与冠状动脉造影相结合完善冠状动脉钙化病变介入治疗。

Abstract:

Coronary artery calcification (CAC) is involved in many complex coronary lesions, which makes percutaneous coronary intervention (PCI) more difficult, and brings great challenges to the clinical intervention. The accurate evaluation of coronary artery calcification in advance is very important for follow-up treatment. In recent years, with the deepening of medical research on coronary artery calcification, the pre-assessment of calcification can be completed through many other clinical coronary artery examinations, avoiding the risk and improving the prognosis of interventional therapy. In this article, four commonly used clinical auxiliary examinations, including computed tomography (CTA), coronary angiography (CAG), intravascular ultrasound (IVUS) and optical coherence tomography (OCT), are analyzed in detail. In addition, we should combine noninvasive methods with coronary angiography to improve the interventional treatment of coronary calcification.