摘要
目的探讨无创性冠脉血流储备（CFR）评价不稳定型心绞痛患者心肌缺血与冠脉狭窄的关系，评估经皮冠脉介入术（PCI）疗效的临床价值。方法86例患者共131支病变冠脉，在冠脉血流显像模式下，分别获取前降支、回旋支和右冠脉中远段静息时血流频谱图，注射ATP开始至停药后5min连续获取冠脉扩张后血流频谱图，测定其静息时及最大冠脉舒张时峰值流速，计算CFR。冠脉造影检查冠脉狭窄率〉70％且CFR≤2．0的患者进行PCI，术后不同时段再次测定CFR。结果①随着冠脉狭窄程度加重，CFR逐渐减低，二者呈负相关（r=-0．803，P〈0．001）。以CFR≤2．0预测冠脉狭窄率〉70％的敏感性为82．7％，特异性为87．7％。②PCI术后CFR值逐渐升高，随访半年CFR〉2．0的病变冠脉占比100％（44／44），随访1年有2支病变前降支出现再狭窄。结论无创性CFR可以评价不稳定型心绞痛患者心肌缺血程度与冠脉狭窄的关系，辅助PCI术适应证选择并评估术后疗效。
Objective To evaluate the value of non invasive coronary flow reserve （CFR） for investigating the relationship between myocardial ischemia and coronary stenosis, and the result after percutaneous coronary intervention （PCI） in patients with unstable angina pectoris. Methods The rest blood flow spectrum and the maximum coronary diastolic blood flow spectrum were obtained respectively for 131 coronary artery lesions including the left anterior descending coronary artery, the left circumflex coronary artery and the right coronary artery in 86 patients from the coronary artery flow imaging of transthoracic Doppler echocardiography, then CFR was calculated. All patients were performed by coronary angiography. Patients with the rate of coronary stenosis〉70% and CFR≤2.0 were treated by PCI. CFR was measured again at different intervals after PCI. Results （D As the degree of stenosis increased, CFR decreased gradually. The coronary stenosis was negatively correlated with CFR （ r = - 0. 803, P 〈0. 001）. The sensitivity of CFR≤2.0 predicting coronary stenosis rate of more than 70 % was 82.7 %, the specificity was 87.7%. （2）CFR of post-PCI was higher than that of per-PCI. With a follow up of half a year, CFR of all coronary arteries was greater than 2.0（44/44）, but restenosis occurred at one year after PCI in two left anterior descending coronary arteries. Conclusions Non-invasive CFR can evaluate the relationship between myocardial ischemia and coronary stenosis, select indications for PCI and evaluate postoperative outcome for patients with unstable angina pectoris.
作者
朱红
郑桂霞
范洁
刘霞
赵连蒙
吴丽英
Zhu Hong;Zheng Guixia;Fan Jie;Liu Xia;Zhao Lianmeng;Wu Liying(Department of Ultrasound,Heilongjiang Provincial Hospital,Harbin 150036,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2018年第8期661-665,共5页
Chinese Journal of Ultrasonography
基金
2013年哈尔滨市科学技术局科技创新人才项目（2013RFXYJ090）
