定量血流分数与冠状动脉造影指导的冠心病介入治疗疗效比较的荟萃分析  

Quantitative Flow Ratio versus Coronary Angiography for Guiding Percutaneous Coronary Intervention in Coronary Heart Disease:a Meta⁃analysis

作　　者：张琳赟 许明 张伟国[1] ZHANG Linyun;XU Ming;ZHANG Weiguo(Department of Cardiology,The People′s Hospital of Suzhou New District,Suzhou 215000,Jiangsu,China)

机构地区：[1]苏州高新区人民医院心内科,江苏苏州215000

出　　处：《中国分子心脏病学杂志》2024年第6期6464-6470,共7页Molecular Cardiology of China

摘　　要：目的对比定量血流分数(quantitative flow ratio,QFR)指导的经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)与冠状动脉造影(coronary angiography,CAG)指导的PCI的临床疗效及预后。方法通过检索PubMed、Embase、Cochrane Library、Web of Science、中国知网期刊数据库(CNKI),筛选2024年1月1日前关于CAG/QFR指导的PCI治疗冠心病的临床疗效进行比较的有关文献,进行荟萃分析。结果共有10篇文献入选,CAG指导的PCI组共3070例患者,QFR指导的PCI组共3303例患者。相对于CAG指导的PCI组,QFR指导的PCI组有更低的主要不良心血管事件(OR=0.49,95%CI:0.42~0.59,P<0.001)、心肌梗死(OR=0.52,95%CI:0.41~0.65,P<0.001)、再次血运重建(OR=0.46,95%CI:0.32~0.65,P<0.001)发生率,而两组间的全因死亡率无明显差异(OR=0.68,95%CI:0.38~1.22,P=0.20)。结论与常规CAG指导的PCI相比,QFR指导的PCI可降低冠心病患者的主要不良心血管事件、急性心肌梗死、再次血运重建的发生率,改善患者预后。Objective Aims to compare the impact of quantitative flow ratio(QFR)guided percutaneous coronary intervention(PCI)and conventional coronary angiography(CAG)guided PCI on clinical efficacy and prognosis.Methods By searching in PubMed,Embase,Cochrane Library,Web of Science and China National Knowledge Infrastructure(CNKI)journal database,relevant literatures on the clinical efficacy of CAG/QFR guided PCI in the treatment of coronary heart disease before January 1,2024 were screened for a meta⁃analysis.Results A total of 10 articles were selected,with 3070 patients in the CAG guided PCI group and 3303 patients in the QFR guided PCI group.Compared to the CAG guided PCI group,the QFR guided PCI group had lower incidence of major adverse cardiovascular events(OR=0.49,95%CI:0.42⁃0.59,P<0.001),myocardial infarction(OR=0.52,95%CI:0.41⁃0.65,P<0.001)and revascularization(OR=0.46,95%CI:0.32⁃0.65,P<0.001),while there was no significant difference in all⁃cause mortality between the two groups(OR=0.68,95%CI:0.38⁃1.22,P=0.200).Conclusion Compared with conventional CAG guided PCI,QFR guided PCI can reduce the incidence of major adverse cardiovascular events,acute myocardial infarction,and revascularization in patients with coronary heart disease,and improve patient prognosis.

关 键 词：定量血流分数 冠状动脉造影 经皮冠状动脉介入治疗 荟萃分析 

分 类 号：R541.4[医药卫生—心血管疾病]