摘要
目的:探讨冠状动脉单支临界病变患者功能性缺血的危险因素,并分析其对于功能性缺血的诊断价值。方法:回顾性分析2014年1月至2021年10月,于北京安贞医院行冠状动脉造影后,因单支临界病变而接受血流储备分数(FFR)检查的460例冠心病患者的临床基本资料及手术情况,分为FFR <0.8和FFR≥0.8两组,比较两组临床资料并分析与FFR <0.8相关的影响因素。结果:两组中男性、BMI、WBC、中性粒细胞、HDL-C、总胆汁酸、尿素、尿酸、肌酐等差异统计学意义(P <0.05)。相关性分析表明,HDL-C和尿酸与FFR间有相关性(R> 0.3,P <0.001)。多因素Logistic回归分析显示尿酸(OR=1.008, 95%CI:1.005~1.012)和总胆汁酸(OR=1.171, 95%CI:1.037~1.321)是FFR <0.8的危险因素,而HDL-C(OR=0.055,95%CI:0.014~0.209)是FFR <0.8的保护因素。尿酸、HDL-C和总胆汁酸的曲线下面积分别为0.723,0.702和0.599。结论:对于冠状动脉单支临界病变,尿酸和HDL-C具有较好的预测能力,对指导是否进行血运重建具有一定的价值。
Objective: To investigate the risk factors of functional ischemia in patients with single intermediate coronary artery stenosis and to analyze its diagnostic value. Methods: We retrospectively analyzed 460 patients who underwent fractional flow reserve(FFR)measurement to determine the functional significance of a single coronary artery intermediate lesion found by conventional coronary angiography at Beijing An Zhen Hospital from January 2014 to October 2021. According to FFR results, patients were divided into 2 groups: FFR < 0.8(n=185) and FFR ≥ 0.8(n=275). We compared the clinical factors between the two groups and analyzed the influence factors for FFR < 0.8. Results: There were statistically significant differences between the two groups regarding male, BMI, white blood cell, neutrophil, HDL-C, total bile acid, urea, UA and creatinine(P<0.05). Spearman’s correlation analysis showed that HDL-C and UA have the correlation relationships with FFR(r > 0.3,P < 0.001). Multivariate Logistic regression analysis showed that UA(OR=1.008, 95%CI:1.005-1.012) and total bile acid(OR=1.171, 95%CI:1.037-1.321) were risk factors for FFR < 0.8, and HDL-C(OR=0.055, 95%CI:0.014-0.209) was a protective factor. The areas under the curve of uric acid, HDL-C and total bile acid for FFR < 0.8 were 0.723, 0.702 and 0.599, respectively.Conclusions: UA and HDL-C showed predictive ability in patients with a single vessel disease of intermediate coronary stenosis.
作者
李凡奇
赵东晖
林小龙
李秋雨
孙浩轩
范谦
LI Fanqi;ZHAO Donghui;LIN Xiaolong;LI Qiuyu;SUN Haoxuan;FAN Qian(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)
出处
《心肺血管病杂志》
CAS
2022年第8期857-862,共6页
Journal of Cardiovascular and Pulmonary Diseases
基金
国家自然科学基金(81771494,81971302)。
关键词
临界病变
血流储备分数
危险因素
尿酸
高密度脂蛋白胆固醇
Intermediate coronary stenosis
Fractional flow reserve
Risk factors
Uric acid
High density lipoprotein cholesterol
