摘要
目的比较血管内超声(IVUS)与血流储备分数(FFR)指导中度冠状动脉狭窄患者行介入治疗的临床获益。方法选取2016年6月—2017年6月四川大学华西医院收治的中度冠状动脉狭窄患者80例,采用抽签法分为IVUS组和FFR组,每组40例。IVUS组患者采用IVUS指导介入治疗,即冠状动脉(左主干除外)近段及中段狭窄处最小管腔面积(MLA)<4 mm2及左主干狭窄处MLA<6 mm2者行介入治疗;FFR组患者采用FFR指导介入治疗,即FFR<0.80者行介入治疗。比较两组患者介入治疗情况及住院时间;随访12个月,比较两组患者主要不良心血管事件发生情况。结果 (1)两组患者辐射暴露时间、造影剂用量、住院时间比较,差异无统计学意义(P>0.05);FFR组患者介入治疗时间、术后在导管室时间短于IVUS组,行介入治疗者所占比例和导管室费用低于IVUS组(P<0.05)。(2)随访期间,两组患者无一例全因死亡;两组患者随访期间主要不良心血管事件发生率比较,差异无统计学意义(P>0.05)。结论与IVUS相比,FFR指导中度冠状动脉狭窄患者行介入治疗能更有效地缩短介入治疗时间,降低介入治疗比例及导管室费用,且未增加短期主要不良心血管事件发生风险,临床获益较大。
Objective To compare the clinical benefits between intravascular ultrasound(IVUS)and fractional flow reserve(FFR)in guiding interventional therapy in patients with moderate coronary artery stenosis.Methods A total of 80 patients with moderate coronary artery stenosis were selected in West China Hospital of Sichuan University from June 2016 to June 2017,and they were divided into IVUS group and FFR group according to picking method,each with 40 cases.Patients in IVUS group received interventional therapy when found the minimum lumen area(MLA)<4 mm2 in proximal and middle nonleft main coronary artery or MLA<6 mm2 in left main coronary artery,while patients in FFR group received interventional therapy when found FFR<0.80.Interventional therapy related indicators,hospital stays and incidence of major adverse cardiovascular events during the 12-month follow-up were were compared between the two groups.Results(1)There was no statistically significant difference in radiation exposure time,contrast agent dosage or hospital stays between the two groups(P>0.05);duration of interventional therapy and post-operative time in catheter room in FFR group were statistically significantly shorter than those in IVUS group,meanwhile proportion of patients undergoing interventional therapy and expense in catheter room were statistically significantly lower than those in IVUS group(P<0.05).(2)No one in the two groups occurred all-cause death,and there was no statistically significant difference in incidence of major adverse cardiovascular events between the two groups during follow-up(P>0.05).Conclusion Compared with IVUS,FFR guided interventional therapy can more effectively shorten the duration of interventional therapy in patients with moderate coronary artery stenosis,reduce the proportion of patients undergoing interventional therapy and expense in catheter room,without increasing the risk of short-term major adverse cardiovascular events,which has better clinical benefits.
作者
尹丽
朱锋
张建明
邵江
杨建军
庞小华
王海龙
YIN Li;ZHU Feng;ZHANG Jianming;SHAO Jiang;YANG Jianjun;PANG Xiaohua;WANG Hailong(Department of Cardiovascular Medicine,the Three Gorges Central Hospital of Chongqing,Chongqing 404000,China)
出处
《实用心脑肺血管病杂志》
2019年第3期63-66,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
冠状动脉狭窄
血管内超声
血流储备分数
介入治疗
疗效比较研究
Coronary stenosis
Intravascular ultrasound
Fractional flow reserve
Interventional therapy
Comparative effectiveness research
