冠状动脉血流储备分数≥0.75在冠状动脉临界病变药物治疗的长期临床疗效及影响因素分析  

Long-term clinical efficacy of coronary borderline lesion with FFR≥0.75 and influence factors analysis after medical treatment

作　　者：韩战营[1] 陈晓杰[1] 卢文杰[1] 吴斌[1] 刘坤[1] 范书霞[1] 李然[1] 邱春光[1] 

机构地区：[1]郑州大学第一附属医院心内科,郑州450052

出　　处：《临床心血管病杂志》2013年第11期849-852,共4页Journal of Clinical Cardiology

摘　　要：目的:评价冠状动脉血流储备分数(FFR)≥0.75在临界病变(直径狭窄50%～70%)强化药物治疗的长期临床疗效,分析影响因素,并确定合适的FFR界值。方法:从2010-01-2010-12连续选择心肌缺血患者318例,冠状动脉造影(CAG)示临界病变,进行FFR检测,选择FFR≥0.75患者入组试验;强化冠心病二级预防,随访时间平均29个月,终点事件为主要心脏不良事件(MACE)。结果:共入组107例,发生MACE 23例(21.50%)。基线资料比较:MACE组患者年龄、BMI、LDL-C、HbA1C及hs-CRP值较大,吸烟、高血压、ACS、二支或多支靶血管数及直接PCI患者较多,狭窄程度重,FFR值较低,差异均有统计学意义(P<0.05)。二级预防后,MACE组LDL-C、HbA1C及hs-CRP仍高于无MACE组(P<0.05)。回归分析得出ACS患者、LDL-C及HbA1C、hs-CRP(随访值)是MACE发生的独立危险因素,而与FFR值无关。结论:临界病变FFR≥0.75进行冠心病二级预防安全有效,ACS患者、LDL-C、HbA1C及hs-CRP是预后影响因素,FFR<0.75指导PCI安全合理。Objective：To evaluate long-term clinical efficacy of coronary borderline lesion（diameter stenosis50%～70%）with fractional flow reserve（FFR）≥0.75after powerful medical treatment,and analyze influence factors,set rational FFR value.Method：The 318 consecutives with myocardial ischemia from 2010-1to 2010-12 were chosed to accept FFR after coronary artery angiography（CAG）demonstrating borderline lesion,chose patients with FFR≥0.75to accept powerful medical treatment,follow-up mean 29 months,endpoint was main adverse cardiac event（MACE）.Result：A total of 107 patients were in the study,and 23 of them had MACE（21.50%）.Baseline characteristic comparison showed that more severe stenosis and lower FFR in MACE group（P0.05）.LDL-C,HbA1 Cand hs-CRP were still significantly higher in MACE group than in non MACE group after medical treatment（P0.05）.Regression analysis showed that ACS patients,LDL-C,HbA1 Cand hs-CRP were all independent risk factors of MACE,and FFR was not.Conclusion：Coronary secondary prevention of borderline lesion with FFR≥0.75is safe and effective.ACS patients,LDL-C,HbA1 Cand hs-CRP are all independent risk factors.FFR0.75 is a rational security cut-off value for PCI.

关 键 词：临界病变 血流储备分数 长期临床疗效 主要心脏不良事件 影响因素 

分 类 号：R541.4[医药卫生—心血管疾病]