血流储备分数与血管内超声对冠状动脉狭窄70%的心绞痛患者治疗方案选择的影响  

The influence of fractional flow reserve and intravascular ultrasound on therapy selection in angina patients with 70%coronary stenosis

作　　者：李惠彬[1] 黄建振[1] 彭俊[1] 高世龙[1] 李国铭[1] 翁奇峰 LI Huibin;HUAMG Jianzhen;PENG Jun;GAO Shilong;LI Guoming;WENG Qifeng(Department of Cardiology,Xiaoshan District First People's Hospital,Hangzhou 311200,China)

机构地区：[1]杭州市萧山区第一人民医院心内科,311200

出　　处：《心电与循环》2024年第1期56-58,66,共4页Journal of Electrocardiology and Circulation

摘　　要：目的比较血流储备分数(FFR)与血管内超声(IVUS)对冠状动脉(下称冠脉)狭窄70%的心绞痛患者治疗方案选择的指导价值。方法选择2019年12月至2022年4月杭州市萧山区第一人民医院心内科行冠脉造影显示狭窄70%的稳定型心绞痛患者80例,其中各有30例分别行IVUS(IVUS组)和FFR(FFR组)检查,20例患者仅予保守治疗(对照组)。当IVUS测得最小管腔面积≤4 mm2、斑块负荷≥70%或FFR值≤0.8时行经皮冠脉介入治疗(PCI)。所有患者行双重抗血小板、调脂、β受体阻滞剂治疗,随访9个月,比较各组冠脉病变分布情况,心绞痛、心肌梗死、血运重建、心源性死亡等主要不良心血管事件(MACE)发生率。结果3组患者冠脉病变分布比较差异无统计学意义(P>0.05)。IVUS组行PCI患者占比多于FFR组,差异有统计学意义(P<0.05),IVUS组和FFR组MACE发生率相似,均低于对照组,差异均有统计学意义(均P<0.05)。结论IVUS和FFR均可指导冠脉狭窄为70%的心绞痛患者治疗方案选择。Objective To compare the value of fractional flow reserve(FFR)and intravascular ultrasound(IVUS)in guiding therapy selection in angina patients with 70%coronary stenosis.Methods Eighty patients with stable angina pectoris who underwent coronary angiography in Xiaoshan District First People's Hospital from December 2019 to April 2022 and showed 70%stenosis were selected.Among them,30 cases each underwent IVUS(IVUS group)and FFR(FFR group)examinations,and 20 cases were only treated conservatively(control group).When the minimum lumen area≤4 mm2 and plaque load≥70%by IVUS,or FFR value≤0.8,percutaneous coronary intervention(PCI)was performed.All patients were given dual antiplatelet therapy,lipid-lowering therapy andβ-receptor blocker therapy,and followed up for 9 months.The distribution of coronary lesions,the main adverse cardiovascular events(MACE)such as angina,myocardial infarction,revascularization,and cardiac death were compared between groups.Results The distribution of coronary artery lesions was not significantly different among the three groups(P>0.05).The number of patients underwent PCI was significantly higher in IVUS group than in FFR group(both P<0.05).The incidences of MACE in IVUS group and FFR group were similar,both were significantly lower than that in the control group(P<0.05).Conclusion Both IVUS and FFR can guide the selection of treatment plans for angina patients with 70%coronary artery stenosis.

关 键 词：心绞痛 冠状动脉狭窄 血流储备分数 血管内超声 

分 类 号：R541.4[医药卫生—心血管疾病]