摘要
目的 探讨血管内超声 (IVUS)对斑块破裂、血栓形成的诊断价值。方法 通过球囊损伤 +高脂 ( 1%胆固醇 )喂养雄性新西兰纯种兔建立动脉粥样硬化动物模型 ,斑块部位转染携带 p5 3基因的重组腺病毒载体 ,促使斑块向不稳定方向转化 ,然后给予鲁塞尔蝰蛇毒 (RVV)和组胺药物触发 ,造成实验性斑块破裂、血栓形成。在药物触发前后对家兔进行IVUS检查 ,结果与组织病理学检查相比较。结果 IVUS发现 14只家兔中有 12只共 18处发生斑块破裂、血栓形成 ,病理学检查发现 14只兔中有 12只共 2 0处斑块破裂、血栓形成。IVUS诊断斑块破裂、血栓的真阳性率为 85 % ,假阴性率为 15 % ,敏感性为 85 % ,特异性 67%。两者在对血栓长度的测量上高度相关 (r =0 .73 ,P <0 .0 1) ,但对横截面积的测量上无相关性(r =0 .19,P >0 .0 5 )。
Objective To explore the value of intravascular ultrasound (IVUS) in diagnosing plaque disruption and arterial thrombosis.Methods Balloon-induced arterial wall injury and then feeding on a diet of 1% cholesterol for 8 weeks, 17 New Zealand white rabbits were established as atherosis(AS) models.At the end of the eighth week, the resulting plaques were incubated transluminally with recombinant adenovirus carrying a p53 transgene. After two weeks, the rabbits underwent pharmacological triggering with Russell viper venom(RVV) and histamine. IVUS was used before and after the rabbits were triggered pharmacologically. The value of IVUS in diagnosing plaque disruption and arterial thrombosis was derived by comparing the results of IVUS with pathologic findings. Results IVUS found that plaques disruption and thrombosis occurred in 12 of the 14 rabbits, totally 18 thrombi. A histologically confirmed plaque disruption and intraluminal thrombus were visualized in 12 of the 14 rabbits, totally 20 thrombi. By comparing the results of IVUS with histopathology, the true positive rate was 85% and false negative rate was 15%, the sensitivity and specificity of IVUS were respectively 85% and 67%. IVUS data correlated well with the histopathology regarding thrombus length(r=(0.73),P<(0.001)), had poor correlation in the measurement of thrombus cross section area(r=(0.19),P>(0.05)). Conclusions IVUS can detect plaque disruption and arterial thrombosis.
出处
《中华超声影像学杂志》
CSCD
2004年第10期777-780,共4页
Chinese Journal of Ultrasonography
基金
国家自然科学基金资助项目 (60 2 71 0 1 5)
卫生部临床学科重点项目 (2 0 0 1 2 943)
