FFR对稳定性心绞痛非前降支临界病变介入治疗的研究  

FFR in Interventional Treatment of Non-anterior Descending Branch Borderline Lesions in Stable Angina Pectors

作　　者：林承曦 梁秀琳[2] 翁川晴 毛庆[2] 徐兢[1] 

机构地区：[1]南京医科大学附属脑科医院,江苏南京210029 [2]广西医科大学第二附属医院,广西南宁530007

出　　处：《大众科技》2018年第11期32-34,共3页Popular Science & Technology

基　　金：广西自然科学基金面上项目(2017GXNSFAA198214)

摘　　要：目的:探讨血流储备分数(fractional flow reserve,FFR)在非前降支临界病变介入治疗中的指导意义。方法:回顾2011年9月至2014年9月在南京脑科医院心内科住院的稳定型心绞痛的患者,收集这些患者中行冠脉造影显示为单支冠脉临界病变并且FFR值>0.8的患者83例共85处血管病变,将83例患者分为非前降支组(包括右冠及回旋支)32例34处病变和前降支组51例共51处病变,分析其随访期间(48个月)的主要不良心血管事件(MajorAdverseCardiovascularEvents,MACE),包括心绞痛发作、室性心律失常、靶血管血运重建、非致死性心肌梗死和心源性死亡。结果:在FFR值>0.8的稳定型心绞痛的患者中,非前降支组和前降支组的患者在临床基线资料如年龄、吸烟史、高脂血症病史、高血压病史等方面均无统计学差异,但非前降支组男性比例明显高于前降支组;通过定量冠状动脉造影测量,发现非前降支组患者的冠脉狭窄程度明显高于前降支组(P=0.000),但前降支组FFR值却明显低于非前降支组(P=0.000)。经过48个月的随访,非前降支组的MACE的发生率明显低于前降支组(P=0.006)。结论:在稳定型心绞痛的患者中,非前降支临界病变的患者较前降支临界病变的患者拥有更好的长期预后。Aim:To explore the clinical significance of fractional flow reserve(FFR)in interventional therapy of non-anterior descending branch borderline lesions.Method:83patients with stable angina pectoris who were admitted to the department of cardiology of Nanjing Brain Hospital from September2011to September2014were selected.The patients were performed coronary angiography,which showed there was single coronary borderline lesion.Moreover,FFR value was greater than0.8.The patients were divided into the non-anterior descending branch group including32patients and34lesions,and the anterior descending branch group including51patients and51lesions.Major Adverse Cardiovascular Events(MACE)during the follow-up period(48months)were analyzed,including angina attack,ventricular arrhythmia,target vessel revascularization,non-fatal myocardial infarction and cardiac death.Results:In the patients with stable angina pectors with FFR>0.8,there were no significant differences between the two groups in clinical baseline data,such as age,smoking,hyperlipidemia,hypertension,etc.However,the proportion of male was significantly higher in the non-anterior descending group than in the anterior descending branch group.The degree of coronary artery stenosis was significantly higher in the non-anterior descending branch group than in the anterior descending branch group(P=0.000).However,the FFR value was significantly lower in the anterior descending branch group than the non-anterior descending branch group(P=0.000).After48months of follou-up,the incidence of MACE was significantly lower in the non-anterior descending branch group(P=0.006).Conclusion:Patients with stable angina pectoris who have borderline lesions in non-anterior descending branch may have better long-term prognosis.

关 键 词：稳定型心绞痛 冠脉临界病变 血流储备分数 

分 类 号：R541[医药卫生—心血管疾病]