冠状动脉血流储备分数测定指导下的冠状动脉临界病变介入治疗疗效观察
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国家自然科学基金(81360022)


Curative Efficacy Observation of Fractional Flow Reserve Guided Percutaneous Coronary Interventions for Borderline Coronary Lesion
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    摘要:

    目的评价冠状动脉血流储备分数(FFR)指导下的冠状动脉临界病变(直径狭窄介于50%~70%)介入治疗疗效。方法连续入选我院2012年1月至2012年12月期间经冠状动脉造影(CAG)证实存在单支冠状动脉临界病变的患者76例,并行FFR测定,其中48例病变血管FFR≥0.75的患者不行经皮冠状动脉介入治疗(PCI)而只给予最佳药物治疗(OMT组),28例病变血管FFR<0.75的患者行PCI并给予最佳药物治疗(PCI+OMT组)。连续随访12个月后,比较两组患者主要心脏不良事件(MACE)的发生率以及西雅图心绞痛量表(SAQ)得分。结果OMT组MACE的发生率与PCI+OMT组比较差异无统计学意义。与基线水平相比,两组患者术后12个月SAQ的5项分数均有提高(P<0.05),两组患者躯体活动受限程度、心绞痛稳定状态、心绞痛发作频率、疾病认识程度方面无明显改善,而治疗满意程度在OMT组优于PCI+OMT组(P<0.05)。结论FFR能够可靠地预测冠状动脉临界病变患者的心肌缺血风险并指导治疗决策,可以避免不必要的PCI,改善患者的机体功能及生活质量。

    Abstract:

    Aim To observe and evaluate the curative efficacy of fractional flow reserve (FFR) guided percutaneous coronary intervention (PCI) for borderline coronary lesion (diameter stenosis was 50%~70%).Methods From 2012 January to 2012 December,76 consecutive patients from our hospital with single branch borderline coronary lesion confirmed by coronary angiography (CAG) were chosen to accept FFR measurements.All the patients were divided into two groups,48 cases with FFR≥0.75 accepted only optimal medical treatment (OMT group),28 cases with FFR<0.75 were accepted PCI and optimal medical treatment (PCI+OMT group).After 12 months’ follow-up,the incidence of major adverse cardiac event (MACE) and the scores of Seattle Angina Questionnaire (SAQ) between the two groups were compared.Results There was no statistically significant difference between OMT group and PCI+OMT group in the incidence of MACE.Compared to the baseline both groups’ scores of SAQ had significantly improved (P<0.05).And the SAQ scores improvement had no statistically significant difference in physical limitation,angina stability,angina frequency and disease cognition level between the patients of OMT group and PCI+OMT group.But the OMT group had more statistically significant improvement than PCI+OMT group in treatment satisfaction level (P<0.05).Conclusion FFR can reliably predict the risk of myocardial ischemia and guide treatment decisions for patients with borderline coronary lesion.It can avoid unnecessary PCI and effectively improve the quality of life and body function of the patients with coronary borderline lesion.

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黄翔,黄定.冠状动脉血流储备分数测定指导下的冠状动脉临界病变介入治疗疗效观察[J].中国动脉硬化杂志,2014,22(12):1231~1235.

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  • 收稿日期:2014-05-19
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