冠状动脉CT血流储备分数在冠状动脉临界狭窄患者心肌缺血诊断中的应用  

Application of coronary CT flow reserve fraction in the diagnosis of myocardial ischemia in patients with borderline coronary artery stenosis

作　　者：周晓婧 提拉柯孜·图尔荪 冯伟 杨和银[1] ZHOU Xiaojing;Tilakezi Tuersun;FENG Wei;YANG Heyin(The Second Department of Cardiology,The First People's Hospital of Kashi,Kashi 844000,China)

机构地区：[1]喀什地区第一人民医院心内二科,新疆喀什844000

出　　处：《山东医药》2023年第27期43-46,共4页Shandong Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(2022D01F12);广东省援疆科技项目(KTPYJ2021022)。

摘　　要：目的评价冠状动脉无创血流储备分数(FFR-CT)对冠状动脉临界狭窄病变(冠状动脉狭窄50%~70%)心肌缺血的诊断效能,为FFR-CT在心肌缺血诊断中的临床应用提供参考。方法67例冠状动脉临界狭窄病变患者,均行冠状动脉CT血管造影(CTA)及冠状动脉造影检查。患者均行冠状动脉血流储备分数(FFR)检查,根据FFR值评估心肌缺血情况。根据冠状动脉CTA影像数据算出FFR-CT值。采用Pearson相关分析FFR值和FFR-CT值之间的相关性。采用ROC评估FFR-CT对冠状动脉临界狭窄病变患者心肌缺血诊断的效能。结果67例患者中FFR值≤0.8的有35例,FFR-CT值≤0.8的有26例。FFR值与FFR-CT值呈正相关(r=0.6668,P<0.01)。共评估血管83支,FFR-CT用于心肌缺血诊断的ROC下面积为0.938(95%CI 0.890~0.985,P<0.01),诊断界值为0.8时,其对心肌缺血诊断的灵敏度87.5%、特异度95.24%、阳性预测值85.29%、阴性预测值79.63%。结论FFR-CT值对冠状动脉临界狭窄病变患者心肌缺血具有较高的诊断效能。Objective To evaluate the diagnostic efficacy of coronary noninvasive flow reserve fraction(FFR-CT)for myocardial ischemia in patients with borderline coronary artery stenosis(50%-70%coronary artery stenosis),and to provide reference for the clinical application of FFR-CT in the diagnosis of myocardial ischemia.Methods Coronary CT angiography(CTA)and coronary angiography were performed in 67 patients with borderline coronary artery stenosis.Coro⁃nary flow reserve fraction(FFR)was examined in all patients,and myocardial ischemia was assessed according to FFR val⁃ue.FFR-CT values were calculated based on coronary CTA imaging data.Pearson correlation was used to analyze the cor⁃relation between FFR values and FFR-CT values.ROC was used to evaluate the efficacy of FFR-CT in diagnosing myocar⁃dial ischemia in patients with borderline coronary artery stenosis.Results Among the 67 patients,FFR value≤0.8 was found in 35 cases,FFR-CT value≤0.8 was found in 26 cases.FFR value was positively correlated with FFR-CT value(r=0.6668,P<0.01).A total of 83 vessels were evaluated.The area under ROC of FFR-CT for the diagnosis of myocardial ischemia was 0.938(95%CI 0.890-0.985,P<0.01).When the diagnostic threshold was 0.8,the sensitivity,specifici⁃ty,positive predictive value and negative predictive value of FFR-CT in the diagnosis of myocardial ischemia were 87.5%,95.24%,85.29%,and 79.63%,respectively.Conclusion The FFR-CT value has a high diagnostic efficiency for myo⁃cardial ischemia in patients with borderline coronary artery stenosis.

关 键 词：冠状动脉血流储备分数 冠状动脉临界狭窄病变 心肌缺血 冠状动脉性心脏病 冠状动脉电子计算机X射线断层扫描技术血管造影 

分 类 号：R541.4[医药卫生—心血管疾病]