血流储备分数在冠状动脉临界病变治疗决策中的应用价值  

Application value of fractional flow reserve in treatment decision-making of coronary artery critical lesions

作　　者：丁浩 施有为[2] 肖建强[2] 李文华[2] 徐波[2] 顾君[2] 张珂瑞 李勇[2] DING Hao;SHI You-wei;XIAO Jian-qiang;LI Wen-hua;XU Bo;GU Jun;ZHANG Ke-rui;LI Yong(Department of Cardiovascular Medicine, Jiangsu University Medical College, Zhenjiang 212013, China;Department of Cardiovascular Medicine, Wujin Hospital Affiliated to Jiangsu University,Changzhou 213017, China)

机构地区：[1]江苏大学医学院心血管内科,江苏省镇江市212013 [2]江苏大学附属武进医院心血管内科

出　　处：《中国心血管病研究》2019年第7期611-614,共4页Chinese Journal of Cardiovascular Research

基　　金：江苏省自然科学基金(BK20140249):江苏省青年医学重点人才培养工程(QNRC2016311 );常州市高层次卫生人才培养工程(2016CZBJ052);常州市科技局应用基础研究计划(CJ20179004).

摘　　要：目的探讨血流储备分数(FFR)在冠状动脉临界病变治疗中应用价值.方法选取2012年12月至2018年2月在江苏大学附属武进医院行冠状动脉造影(CAG)检查的冠状动脉临界病变患者136例,根据是否接受FFR测量分为FFR组(FFR指导的介入或药物治疗,85例)和CAG组(仅行药物治疗,51例),比较两组临床资料、血管病变情况.进行为期(2.21±1.14)年的随访,观察主要心血管不良事件(MACE)(包括心源性死亡、非致死性心肌梗死及再次血运重建)及心绞痛发作的情况.结果两组患者性别、年龄、高血压、高脂血症、糖尿病、吸烟率、用药情况比较未见统计学差异(P>0.05);CAG组共有69处病变;FFR组共有123处病变,两组血管病变情况比较未见统计学差异(P>0.05);FFR组MACE发生率为5.9%,显著低于CAG组的25.5%(P<0.05).FFR组心绞痛发生率为25.9%,显著低于CAG组的43.1%(P<0.05).结论 FFR联合CAG指导的冠状动脉临界病变的治疗决策效果优于CAG单独指导的治疗效果,可有效降低患者MACE发生率.Objective To investigate the value of fractional flow reserve (FFR) in the treatment of coronary artery critical lesions. Methods From December 2012 to February 2018, 136 patients with coronary artery critical lesions underwent coronary angiography (CAG) in Wujin Hospital Affiliated to Jiangsu University were selected. They were divided into FFR group(intervention or medication guided by FFR, n=85) and CAG group (medication only, n=51), according to whether they accepted FFR measurement guiding or not. The clinical data and vascular lesion of the two groups was compared. The main adverse cardiovascular event (MACE), including cardiac death, non-fatal myocardial infarction and revascularization and angina pectoris, were observed during a follow-up period of (2.21 ±1」4) years. Results There was no significant difference in gender, age, hypertension, hyperlipidemia, diabetes? smoking rate and drug use between the two groups (P> 0.05). There were 69 lesions in CAG group and 123 lesions in FFR group. There was no significant difference in vascular lesions between the two groups(P>0.05). The incidence of MACE in FFR group was 5.9%, significantly lower than 25.5% in CAG group (P<0.05). The incidence of angina pectoris in FFR group was 25.9%, significantly lower than 43.1% in CAG group (P<0.05). Conclusion The decision-making effect of FFR combined with CAG in the treatment of coronary artery critical lesions is better than that of CAG alone, which can effectively reduce the incidence of MACE in patients.

关 键 词：冠状动脉疾病 冠状动脉血流储备分数 经皮冠状动脉介入治疗 临界病变 

分 类 号：R541.4[医药卫生—心血管疾病]