血流储备分数在左冠状动脉主干分叉病变中的应用  

Clinical analysis of fractional flow reserve in left main coronary artery with bifurcation lesion

作　　者：韩战营[1] 陈晓杰[1] 卢文杰[1] 吴斌[1] 刘坤[1] 李然[1] 范书霞[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》2014年第5期377-380,共4页Journal of Clinical Cardiology

摘　　要：目的:分析左冠状动脉(冠脉)主干分叉病变处主支置入支架后分支血管(回旋支)口部受累后血流储备分数(FFR)指导介入治疗的安全合理性。方法:连续选择35例左主干分叉病变的患者,给予LM-LAD跨越式支架置入术(Cross-over),经定量冠脉造影(QCA)测量术后LCX口部狭窄程度,狭窄≥75%给予FFR测量,FFR<0.8给予支架干预,并随访主要心脏不良事件(MACE)。结果:术后FFR<0.8组的LCX口部最小管腔直径最小,狭窄<75%组最大[(0.2±0.6)mm∶(0.6±0.4)mm∶(1.5±0.2)mm,P<0.001];FFR<0.8组的LCX口部狭窄最重,狭窄<75%组最轻[(94.2±2.5)%∶(81.6±4.7)%∶(53.8±13.1)%,P<0.001];FFR<0.8组的FFR值比FFR≥0.8组显著减小[(0.71±0.11)∶(0.85±0.12),P<0.001],两组QCA数值与FFR数值显著相关(r=-0.94,P<0.001)。3组MACE比较,差异均无统计学意义。结论:FFR可显著减少左主干分叉病变Cross-over支架术后受累LCX口部的介入治疗,且安全合理。Objective：To analyze the safety and rationality of intervational therapy according to fractional flow reserve（FFR）in ＂jailed＂ ostium of side branch（left circumflex,LCX）after stenting with cross-over technique. Method：The 35consecutives with left main coronary bifurcation received LM-LAD Cross-over technique stenting, then mearsured jailed LCX ostium with quantitative coronary angiography（QCA）,if stenosis≥75%continued to accepted FFR,FFR〈0.8 received re-stent implanted and follow-up for main cardiac adverse events（MACE）. Result：The minimum lumen diameter（MLD）of LCX ostium in FFR0.8group after stenting was least,the largest in stenosis 75% group[（0.2±0.6）mm vs（0.6±0.4）mm vs（1.5±0.2）mm,P〈0.001];the stenosis of LCX ostium was most severy in FFR0.8group,however,the least in stenosis75% group[（94.2±2.5）% vs（81.6±4.7）% vs（53.8±13.1）%,P〈0.001];the FFR was significantly less in FFR0.8group than that in FFR≥0.8group[（0.71±0.11）vs（0.85±0.12）,P〈0.001],the QCA and FFR in the two groups were significantly correlation（r=-0.94,P〈0.001）.The MACE rate in the three groups were not significant different. Conclusion：FFR may significantly decrease the interventional therpy of jailed LCX ostium after Cross-over stenting in left main coronary bifurcation.

关 键 词：血流储备分数 左主干 分叉病变 最小管腔直径 Cross-over支架术 主要心脏不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]