摘要
目的探讨血流储备分数（FFR）在指导冠状动脉临界病变中的临床疗效及应用价值。方法选取2013年1—6月在新疆医科大学附属中医医院接受冠状动脉造影（CAG）评估冠状动脉管腔直径狭窄为50%～70%的临界病变,并接受FFR测量的患者43例,根据FFR值,以0.75为界值分组。FFR≥0.75者为延迟PCI组予以药物治疗;FFR〈0.75者采用随机数字表法分为药物治疗组（阿司匹林、氯吡格雷、他汀类）和PCI＋药物治疗组（PCI组）。患者均于治疗后6个月时进行随访,观察主要心血管不良事件（MACE）（心源性猝死、非致死性心肌梗死、再次血运重建等）以及再发心绞痛情况。结果根据FFR值,PCI组12例,药物治疗组11例,延迟PCI组20例。3组患者性别、年龄、吸烟率、高血压、糖尿病、高脂血症、冠心病家族史、射血分数、住院期间药物应用及术后6个月药物应用比较,差异均无统计学意义（P〉0.05）。3组患者病变部位、参考血管直径、血管狭窄程度、最小管腔直径比较,差异均无统计学意义（P〉0.05）。治疗后6个月时,3组患者均未发生心源性猝死、心肌梗死,PCI组和延迟PCI组均未发生再次血运重建,仅药物治疗组出现2例（18.0%）再次血运重建。3组再发心绞痛率比较,差异无统计学意义（P=0.832）。结论在冠状动脉介入治疗中处理临界病变时,通过测定FFR值指导治疗,在短期内并未增加不良心血管事件,并可以更好地指导PCI治疗。
Objective To explore the clinical effects and application values of fractional flow reserve（ FFR） in guiding coronary intervention for critical lesions. Methods 43 patients with coronary critical lesions received CAG evaluation and FFR in Xinjiang TCM Hospital from January to June 2013 were divided into groups according to FFR values（ taking 0. 75 as dividing value）. The patients with FFR≥0. 75 were divided into defer PCI group（ given drug treatment）,the patients with FFR 〈0. 75 were divided randomly into groups drug treatment（ DT group; given aspirin,clopidogrel,statins）,PCI ＋ DT group（ PCI group）. The patients were followed up in months 6 after treatment to observe the major adverse cardiac events（ MACE）and recurrence of angina pectoris（ AP）. Results According to FFR values,there were 12 cases in PCI ＋ DT group,11 in DT group,20 in defer PCI group. There was no significant difference in gender,age,smoking rate,hypertension,diabetes,hyperlipidemia,the proportion of family history,ejection fraction,drug use during hospitalization or in months 6 after treatment among 3 groups（ P〉0. 05）; there was no difference in diseased region,reference diameter,angiostegnosis percentage,minimum lumen diameter（ P〉0. 05）. In the follow-up in months 6 after treatment,no cardiac sudden death,myocardial infarction occurred in 3 groups,there was no patient having revascularization in groups PCI ＋ DT,defer PCI,but there were 2 cases（ 18. 0%） in DT group. There was no difference in rate of AP recurrence（ P = 0. 832）. Conclusion In dealing critical lesions in coronary intervention,FFR values do not increase MACE but can guide PCI treatment better.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第35期4163-4165,4169,共4页
Chinese General Practice
