血流储备分数在指导冠状动脉多支病变治疗策略中的作用

被引：6

作者：

杨瑞鑫 ^{[1
,2
]}

陈青 ^{[2
]}

张小天 ^{[2
]}

孙冬冬 ^{[2
]}

李成祥 ^{[2
]}

机构：

[1] 第四军医大学学员旅

[2] 第四军医大学第一附属医院心血管内科

来源：

中国介入心脏病学杂志 | 2013年 / 21卷 / 05期

关键词：

冠状动脉疾病; 血流储备分数; 血管造影术;

D O I：

暂无

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

摘要：

目的评估冠状动脉造影筛选的冠状动脉多支病变与心肌缺血的关系,阐明血流储备分数(FFR)在指导冠状动脉多支病变治疗策略中的作用。方法纳入96例患者218处冠状动脉病变,根据FFR值分为两组,FFR>0.80组(113处)及FFR≤0.80组(105处)。结果 FFR≤0.80组冠状动脉直径狭窄程度更高[(66.2±10.5)%比(59.1±13.8)%,P<0.001]、面积狭窄百分比更大[(87.3±7.7)%比(81.4±10.9)%,P<0.001]、最小管腔直径更小[(0.86±0.36)mm比(1.18±0.49)mm,P<0.001],上述指标与FFR值无明确相关(相关系数分别为r=-0.286,P<0.001;r=-0.282,P<0.001)。冠状动脉最小管腔直径与FFR值呈正相关(r=0.364,P<0.001)。冠状动脉造影筛选的96例患者中,26例为三支病变,70例为双支病变;经FFR测量后,缺血相关的三支病变10例,两支病变29例,单支病变17例。QCA冠状动脉造影直径狭窄≥70%,FFR>0.80的病变为21处(9.6%);QCA冠状动脉造影直径狭窄<70%,FFR≤0.80的病变为53处(24.3%)。QCA冠状动脉造影直径狭窄≥70%,FFR≤0.80的病变为52处(23.9%)(Matches);QCA冠状动脉造影直径狭窄<70%,FFR>0.80的病变为92处(42.2%)(Matches)。QCA冠状动脉造影面积狭窄≥70%,FFR>0.80的病变为89处(40.8%)(Mismatches);QCA冠状动脉造影面积狭窄≥70%,FFR≤0.80的病变为105处(48.2%)(Matches);QCA冠状动脉造影面积狭窄<70%,FFR>0.80的病变为24处(11.0%)(Matches)。结论 FFR在指导冠状动脉多支病变治疗策略中具有重要意义,可显著降低缺血相关靶病变个数。

引用

页码：279 / 283

页数：5

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