OCT在冠心病诊疗中的应用及展望

Application and Prospect of OCT in the Diagnosis and Treatment of Coronary Heart Disease

摘要: 冠状脉粥样硬化性心脏病(coronary atherosclerotic heart disease, CHD)简称：冠心病，是一种全球广泛存在的心脏慢性缺血缺氧性疾病，同时也是全球发病率最高发以及病死率最高的冠状动脉疾病。临床上常用的冠心病检查如：心脏彩超、心脏核磁、心脏CT、心脏同位素心肌显像、冠状动脉造影、IVUS等，它们的空间分辨率均较低，而值得我们关注的光学相干断层成像(optical coherence tomography, OCT)技术不仅在冠心病诊断方面有突出贡献，而且在冠心病介入治疗方面进一步展现出独特性，其利用不同深度生物组织的反射光被干涉仪捕捉并记录的原理，再由计算机绘制出简单明了的图像。通过OCT技术，我们能够准确地进行血管壁成像，其精度达到10 μm级别，这一优势在理解冠状动脉粥样硬化病变、制订并改善介入治疗方案、评估支架植入后的效果和长期追踪中都起着关键作用。本篇总结了OCT在冠心病诊疗中的应用现状及未来展望。

Abstract: Coronary atherosclerotic heart disease (CHD), abbreviated as coronary heart disease (CHD), is a globally widespread chronic ischemic and hypoxic disease of the heart, and is also the coronary artery disease with the highest morbidity and mortality rates worldwide. Commonly used clinical coronary heart disease examination such as: cardiac ultrasound, cardiac nuclear magnetic resonance imaging, cardiac CT, cardiac isotope myocardial imaging, coronary angiography, IVUS, etc., their spatial resolution are relatively low, and it is worth our attention that the optical coherence tomography (OCT) technology has not only made an outstanding contribution to the diagnosis of coronary heart disease, but has also further demonstrated its uniqueness in the interventional therapy of coronary heart disease, which utilizes the principle that the reflected light from biological tissues at different depths is captured and recorded by interferometers, and then computerized to produce a simple and clear image. Using OCT, we were able to achieve 10-μm resolution of the vessel wall, an advantage that makes it important to understand coronary atherosclerotic lesions, to develop and optimize interventional strategies, to evaluate the effects of stenting, and to follow up in the long term. This article summarizes the current status and future prospects of OCT in the diagnosis and treatment of coronary heart disease.