校正TIMI计帧法与微循环阻力指数诊断冠状动脉微循环障碍的对比研究  

Comparative study of corrected TIMI frame count method and index of microcirculatory resistance to diagnose coronary microcirculation dysfunction

作　　者：徐冰[1] 李益民[2] 何胜虎[1] 陈述[1] 纪军[1] 程铖[1] 张晶[1] 梅宏斌[1] 张勤[3] 

机构地区：[1]江苏省苏北人民医院心血管内科,江苏扬州225001 [2]南京市胸科医院心内科,江苏南京210029 [3]江苏省苏北人民医院医学影像科,江苏扬州225001

出　　处：《中国实用内科杂志》2016年第6期489-492,共4页Chinese Journal of Practical Internal Medicine

基　　金：江苏省卫生厅科研基金面上项目(H201354)

摘　　要：目的探讨校正的TIMI计帧法(corrected TIMI frame count,CTFC)和微循环阻力指数(index of microcirculatory resistance,IMR)在疑似心绞痛而冠状动脉造影正常患者中的相关性,分析CTFC诊断冠状动脉微循环功能障碍的价值。方法入选江苏省苏北人民医院2013年1月至2015年4月因存在疑似心绞痛症状而行冠状动脉脉造影正常的患者48例,分别测算静息相校正TIMI帧数(B-CTFC)、充血相校正TIMI帧数(H-CTFC)和IMR值,将B-CTFC和H-CTFC相除得出患者的冠状动脉血流储备(CFRCTFC)。根据IMR值分为IMR阳性组(IMR≥25)和IMR阴性组(IMR<25)。比较两组间CTFC、CFRCTFC的差异,并分析CTFC、CFRCTFC与IMR的相关性。结果 IMR阳性组高血压和糖尿病患者比例高于IMR阴性组(75.0%对46.4%,60%对28.6%),差异有统计学意义(P<0.05);IMR阳性组与IMR阴性组B-CTFC比较差异无统计学意义(26.5±7.9对23.5±7.5,P>0.05);IMR阳性组H-CTFC高于IMR阴性组(14.3±7.2对10.1±5.3,P<0.05);IMR阳性组CFRCTFC低于IMR阴性组(2.1±0.6对2.5±0.5,P<0.05);CFRCTFC与IMR显著相关(r=-0.56,P<0.01)。结论校正的TIMI计帧法测定的CFRCTFC与IMR有良好的相关性,对临床评估冠状动脉微循环功能障碍有一定的应用价值。Objective To discuss the correlation between corrected TIMI Frame Count（CTFC）and the index ofmicrocirculatory resistance （IMR） in patients with suspected angina but normal coronary angiography, and then demonstrate the possibility of the diagnosis of microcirculation dysfunction by CTFC. Method This study selected a total of 48 patients with suspected angina, making sure the coronary artery had no stenosis. First we calculated the baseline CTFC（B-CTFC）, hyperemic CTFC（H-CTFC） and IMR.H-CTFC divided by B-CTFC was CFRCTFC.According to the number of IMR, we divide the patients into the IMR positive group（IMR≥25） and IMR negative group（IMR〈25）. Compare the differences of CTFC and CFRCTFC between the two groups, and analyze the correlation of CTFC and CFRCTFC with IMR. Results The proportion of the patients with hypertension and diabetes in IMR positive group was higher than that in the IMR negative group （75.0% vs 46.4%, 60% vs 28.6%,P〈0.05）; B-CTFC in two groups had no difference（26.5±7.9 vs 23.5±7.5, P〉0.05）; IMR positive group＇s H-CTFC was higher than the IMR negative group（14.3±7.2 vs 10.1±5.3, P〈0.05）; IMR positive group＇s CFRCTFC was lower than the IMR negative group （2.1±0.6 vs 2.5±0.5, P〈0.05）; CFRCTFC had significant correlation with IMR （r=-0.56, P〈0.01）. Conclusion CFRCTFC calculated from CTFC has a notable association with IMR. CFRCTFC is clinically valuable in the evaluation of coronary microcirculation dysfunction.

关 键 词：冠状动脉微循环障碍 校正的TIMI计帧法 微循环阻力指数 

分 类 号：R541[医药卫生—心血管疾病]