急性ST段抬高型心肌梗死患者血流储备分数与冠状动脉造影定量分析的关系  

The relationship between fractional flow reserve and quantitative coronary angiography in patients with acute ST-segment elevation myocardial infarction

作　　者：王丙剑[1] 耿金[1] 李倩君[1] 胡婷婷[1] 徐标 马树人[1] WANG Bing-jian;GENG Jin;LI Qian-jun;HU Ting-ting;XU Biao;MA Shu-ren(Department of Cardiology, Huaian First People＇s Hospital, Nanjing Medical University, Huaian Jiangsu 223300, Chin)

机构地区：[1]南京医科大学附属淮安第一医院心内科,江苏淮安223300 [2]南京医科大学附属鼓楼医院心内科

出　　处：《中华高血压杂志》2018年第3期248-252,共5页Chinese Journal of Hypertension

基　　金：江苏省青年医学人才项目(QNRC2016432);江苏省卫计委面上课题(H2017011)

摘　　要：目的探索血流储备分数(FFR)与冠状动脉造影定量分析(QCA)的关系。方法入选135例行择期经皮冠状动脉介入(PCI)治疗的ST段抬高型心肌梗死(STEMI)且测量FFR的患者,采用线性回归分析梗死相关血管FFR与QCA的关系。结果狭窄程度在50%~<70%的病变有22例,其中27.3%的FFR<0.80,而狭窄程度在70%~<90%的病变有62例,其中21.0%的FFR≥0.80,狭窄程度在90%~99%的病变有51例,其中3.9%的FFR≥0.80。Pearson相关分析示QCA参数狭窄程度、病变长度与FFR呈负相关(分别r=-0.677、-0.538),最小管径与FFR呈正相关(r=0.676),均P<0.001。多元线性回归分析结果显示,狭窄程度(B=-0.006)、病变长度(B=-0.009)和最小管径(B=0.195)是FFR的影响因素(均P<0.001)。结论急性心肌梗死后行择期PCI术患者的QCA与FFR相关。Objective To explore the relationship between fractional flow reserve （FFR） and quantitative coronary angiography （QCA）. Methods A total of 135 patients with acute ST-segment elevation myocardial infarction （STEMI） were enrolled in this study, who underwent delayed percutaneous coronary intervention （PCI） and the measurement of FFR. Linear regression analysis was used to assess the relationship between FFR and QCA of the infarct-related artery. Results There were 22 patients with diameter stenosis of 50%-70%, 27.3% of which had FFR〈0.80. There were 62 patients with diameter stenosis of 70%- 90%, 21.0% of which had FFR≥0.80. There were 51 patients with diameter stenosis of 90 %- 99 %, 3.9 % of which had FFR≥0.80. Pearson correlation analysis showed that parameters of QCA, including diameter stenosis and lesion length were negatively associated with FFR （r=- 0. 677, -0. 538, respectively）, while minimal lumen diameter was positively associated with FFR （r= 0. 676）, all P〈0. 001. Multivariate linear regression analysis revealed that diameter stenosis （B=-0. 006）, lesion length （B=- 0. 009） and minimal lumen diameter （B= 0. 195） were influencing factors for FFR （all P〈0. 001）. Conclusion QCA was associated with FFR in patients with STEMI who underwent delayed PCI.

关 键 词：血流储备分数 冠状动脉造影定量分析 ST段抬高型急性心肌梗死 经皮冠状动脉介入 

分 类 号：R542.22[医药卫生—心血管疾病]