快速傅里叶变换分析冠状动脉旁路移植术中不同桥血管的血流波形特征及其意义  

Characteristics of blood flow waveform of different grafts in coronary artery bypass grafting based on Fast Fourier transform and their significances

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,北京100020

出　　处：《吉林大学学报（医学版）》2021年第5期1250-1257,共8页Journal of Jilin University：Medicine Edition

基　　金：北京市科委首都临床诊疗技术研究及示范应用项目(Z191100006619036)。

摘　　要：目的:基于血流频谱特征探讨冠状动脉旁路移植术(CABG)中左侧乳内动脉(LIMA)、大隐静脉(SVG)、乳内动脉+大隐静脉复合桥(LIMA+SVG)和桡动脉(RA)术后通畅率上存在差异的原因,阐明其临床意义及应用价值。方法:收集132例行CABG患者的临床资料,获取术后随访中未病变桥血管的血流波形,按照桥血管类型分为LIMA组、SVG组、LIMA+SVG组和RA组,分别进行快速傅里叶变换(FFT),通过统计学方法比较各组桥血管频谱中各波峰(按频率由低至高命名为H1~Hn)的频率和幅度值的差异,分析不同种类桥血管远期通畅率差异的影响因素。结果:LIMA组与SVG组患者第一谐波H1频率相等,LIMA组其他谐波频率小于SVG组。LIMA+SVG组H1和H2频率高于LIMA组,H3频率小于LIMA组,且LIMA+SVG组可见第四谐波差异(H4)。与SVG组比较,LIMA+SVG组H1频率更高,H2和H3频率更低。RA组H1和H2频率较LIMA组及SVG组均更高。4组血管幅度值比较差异有统计学意义(χ^(2)=8.131,P=0.043),SVG组血管幅度值高于LIMA组(P=0.006),LIMA+SVG组和RA组血管幅度值与LIMA组比较差异无统计学意义(P=0.812,P=0.977)。结论:LIMA和RA桥血管内血液流动更平稳,不易形成湍流,是CABG术中的优先选择;LIMA+SVG具有一定的动脉特征,在结构上较SVG有一定优势;SVG内血流最容易形成湍流,应尽可能减少使用。Objective:To explore the reasons for the differences in the patency rates of left internal mammary artery(LIMA),great saphenous vein(SVG),internal mammary artery+great saphenous vein composite bridge(LIMA+SVG)and radial artery(RA)after coronary artery bypass grafting(CABG)based on the characteristics of blood flow spectrum,and to clarify the clinical significance and application value.Methods:The clinical materials of 132 patients underwent CABG were collected.The blood flow waveforms of patent grafts in follow-up were obtained and divided into LIMA group,SVG group,LIMA+SVG group and RA group according to the types for Fast Fourier Transform(FFT).The differences in the frequencies and amplitudes of wave peaks(which were named H1-Hn according to frequency from low to high)in the spectrum of grafts in various groups were compared with the statistic method and the factors affecting the differences in the long-term patency rates of different types of grafts were analyzed.Results:The frequency of first harmonic(H1)in LIMA group was equal to SVG group,and the others in LIMA group were lower than those in SVG group.The frequencies of H1 and H2 in LIMA+SVG group were higher than those in LIMA group,the frequency of H3 was lower,and the fourth harmonic H4 was visible.Compared with SVG group,the frequency of H1 in LIMA+SVG group and the frequencies of H2 and H3 were lower.The frequencies of H1 and H2 in RA group were higher than those in LIMA group and SVG group.The differences in the amplitudes between four groups were statistically significant(χ^(2)=8.131,P=0.043);the amplitude in SVG group was higher than that in LIMA group(P=0.006),and there were no significant differences in the amplitudes between LIMA+SVG group,RA group and LIMA group(P=0.812,P=0.977).Conclusion:The blood flow in LIMA and RA is more stable and less turbulent,which are the preferred choice in CABG operation.LIMA+SVG has partly arterial characteristics and the structural advantages compared with SVG.The flow of SVG is easier to turbulence and SVG shou

关 键 词：冠状动脉旁路移植术 通畅率 术中瞬时流量测定 快速傅里叶变换 

分 类 号：R654.2[医药卫生—外科学]