快速傅里叶变换处理后TTFM对旁路移植血管病变预测的有效性评价  

Evaluation of the effectiveness of TTFM processed by fast Fourier transform in predicting graft failure

作　　者：贾彦雄 高杰[2] 苏丕雄[2] Jia Yanxiong;Gao Jie;Su Pixiong(Third Clinical Medical College,Capital Medical University,Beijing 100069,China;Department of Cardiac Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学第三临床医学院,北京100069 [2]首都医科大学附属北京朝阳医院心脏外科,100020

出　　处：《中华胸心血管外科杂志》2021年第4期245-249,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨即时血流测量(TTFM)波形经快速傅里叶变换(FFT)处理后评价冠状动脉旁路移植(CABG)术后旁路移植血管通畅率的可行性及预测价值。方法对2015年1月至2017年2月期间114例在北京朝阳医院行CABG的患者术中记录的TTFM波形进行FFT处理,获取相关参数。按照旁路移植血管不同分为左乳内动脉组(LIMA组,113支)和大隐静脉组(SVG组,207支)。术后随访CTCA,评价处理后参数对旁路移植血管病变的预测价值。结果全组术中共移植旁路血管320支,总通畅率80.3%(257/320)。LIMA组术后通畅率89.4%(101/113),SVG组术后通畅率75.4%(156/207)。经FFT转化后,全组病变与非病变旁路移植血管的主波幅度值(H0)、第1谐波幅度值(H1)、第1谐波频率(P1)和H0/H1,LIMA组的H1、P1,SVG组的H0、H1和P1,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示全组H0降低(OR=0.92,95%CI:0.90~0.95)和P1升高(OR=2.26,95%CI:1.64~3.10)使旁路移植血管病变风险增加。LIMA组中,H1升高(OR=3.57,95%CI:1.79~7.12)和P1升高(OR=1.53,95%CI:1.01~2.33)使旁路移植血管病变风险增加。SVG组中,H0降低(OR=0.83,95%CI:0.77~0.89)、H1降低(OR=0.05,95%CI:0.02~0.14)和P1升高(OR=9.53,95%CI:3.04~29.86)使旁路移植血管病变风险增加。ROC曲线显示全部旁路移植血管组中H0和P1具有中等程度的预测准确性;LIMA组中H1、H0/H1具有中等程度预测准确性;SVG组中H0、H1具有较高程度预测准确性,P1具有中等程度预测准确性。结论TTFM波形经FFT处理后的获得参数对CABG术后旁路移植血管通畅率具有预测价值。Objective To explore the feasibility and predictive value of Transit-Time Flow Measurement(TTFM)processed by Fast Fourier Transform(FFT)in evaluating the patency of grafts after coronary artery bypass grafting(CABG).Methods The TTFM waveforms recorded during the operation of 114 CABG patients in our hospital from January 2015 to February 2017 were processed by FFT,the patients were followed up with CTCA after operation to evaluate the predictive value for graft failure.Results 320 grafts were grafted with the patency rate of 80.3%(257/320).The patency rate of LIMA group was 89.4%(101/113),and SVG group was 75.4%(156/207).H0,H1,H0/H1,and P1 of all grafts,H1and P1 in LIMA group,and H0,H1,P1 in SVG group were significantly different(P<0.05).In logistic regression,decreasing of H0(OR=0.92,95%CI:0.90-0.95)and increasing of P1(OR=2.26,95%CI:1.64-3.10)in all graft groups increased the risk of graft failure.In the LIMA group,increasing of H1(OR=3.57,95%CI:1.79-7.12)and P1(OR=1.53,95%CI:1.01-2.33)increased the risk of graft failure.In the SVG group,decreasing of H0(OR=0.83,95%CI:0.77-0.89)and H1(OR=0.05,95%CI:0.02-0.14),increasing of P1(OR=9.53,95%CI:3.04-29.86)increased the risk of graft failure.The ROC curve showed that H0 and P1 had a moderate degree of predictive accuracy in all graft groups.H1 and H0/H1 had a moderate degree of predictive accuracy in LIMA group,and H0 and H1 had a high degree of prediction,P1 had a moderate degree of predictive accuracy in SVG group.Conclusion TTFM waveform processed by FFT has predictive value for the patency rate of CABG.

关 键 词：冠状动脉旁路移植术 血管通畅率 快速傅里叶变换 

分 类 号：R654.2[医药卫生—外科学]