血管内超声和血流储备分数在冠心病合并糖尿病患者冠状动脉介入治疗中的临床应用研究  

Clinical effects of intravascular ultrasound and fractional flow reserve on coronary artery intervention in patients with coronary heart disease complicated with diabetes mellitus

作　　者：何皓[1] 曲益萱 

机构地区：[1]南方医科大学南海医院心内科,广东528244

出　　处：《中国临床新医学》2017年第6期528-531,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨血管内超声(IVUS)和血流储备分数(FFR)在合并糖尿病的冠心病患者中冠状动脉介入治疗中的临床应用。方法选取2013-02~2015-03广东省人民医院及南海医院住院的行冠状动脉介入治疗的合并糖尿病的冠心病患者136例。其中对照组57例以冠状动脉造影(CAG)指导,IVUS组34例以CAG+IVUS指导,FFR组45例以CAG+FFR指导。比较三组患者冠脉支架置入数量、手术中造影剂用量、总住院费用、手术时间、出院1年后心绞痛发生情况以及其他主要心脏不良事件发生率。结果 IVUS组的支架直径明显高于FFR组和对照组(P<0.05),而对照组和FFR组比较差异无统计学意义(P>0.05)。对照组的置入支架数明显多于FFR组和IVUS组(P<0.05),而FFR组和IVUS组比较差异无统计学意义(P>0.05)。对照组的造影剂用量显著高于IVUS组和FFR组,且IVUS组显著高于FFR组(P<0.05)。对照组的手术费用显著高于FFR组和IVUS组(P<0.05)。结论通过测定冠状动脉病变FFR及IVUS的指导介入治疗中可以减少支架置入的数量、造影剂用量及手术费用,减少术后心绞痛发生,对合并糖尿病的冠心病患者中冠状动脉介入治疗起到了较好的指导作用。Objective To investigate the clinical effects of intravascular ultrasound （IVUS） and fractional flow reserve（FFR） on coronary artery intervention in patients with coronary heart disease complicated with diabetes mellitus. Methods 136 patients with coronary heart disease and a diabetic history were enrolled and were divided in- to the control group（ under CAG guidance, n = 57 ） , CAG ＋ IVUS group（ under CAG puls IVUS guidance, n = 34 ） and FFR group（under CAG plus FFR guidance, n = 45）. The amount of implanted coronary stents and contrast a- gent, the total cost of hospitalization, the operative time, and the reoccurrence of angina and the incidence of major adverse cardiac events were compared among the three groups one year after discharge from the hospital. Results The diameters of implanted stents in the IVUS group were significantly larger than those in the FFR group and the control group（ P 〈 0. 05 ） , but there was no significant difference between the control group and the FFR group （ P 〉 0. 05）. The number of stents in the control group was significantly larger than that in the FFR group or the IVUS group（ P 〈0. 05 ） , but there was no significant difference between the FFR group and the IVUS group（ P 〉 0. 05 ）. The dosage of contrast medium in the control group was significantly higher than that in the IVUS group or the FFR group, and the dosage of contrast medium in the IVUS group was significantly higher than that in the FFR group（ P 〈 0.05）. The hospitalization costs of the control group were significantly higher than those in the FFR group or the IVUS group（ P 〈 0.05）. Conclusion The auxiliary measurement of FFR and IVUS interventional treatment can reduce the number of implanted stents and the dosage of contrast agent, and the costs of the hospitalization and reduce the incidence of angina after PCI in the patients with coronary heart disease.

关 键 词：合并糖尿病的冠心病 血管内超声 血流储备分数 

分 类 号：R54[医药卫生—心血管疾病] R58[医药卫生—内科学]