中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
35期
4163-4165,4169
,共4页
冠状动脉介入治疗%临界病变%血流储备分数
冠狀動脈介入治療%臨界病變%血流儲備分數
관상동맥개입치료%림계병변%혈류저비분수
Coronary intervention%Critical lesions%Fractional flow reserve
目的:探讨血流储备分数( FFR )在指导冠状动脉临界病变中的临床疗效及应用价值。方法选取2013年1—6月在新疆医科大学附属中医医院接受冠状动脉造影( CAG)评估冠状动脉管腔直径狭窄为50%~70%的临界病变,并接受FFR测量的患者43例,根据FFR值,以0.75为界值分组。FFR≥0.75者为延迟PCI组予以药物治疗;FFR<0.75者采用随机数字表法分为药物治疗组(阿司匹林、氯吡格雷、他汀类)和 PCI +药物治疗组( PCI组)。患者均于治疗后6个月时进行随访,观察主要心血管不良事件( MACE)(心源性猝死、非致死性心肌梗死、再次血运重建等)以及再发心绞痛情况。结果根据FFR值,PCI组12例,药物治疗组11例,延迟PCI组20例。3组患者性别、年龄、吸烟率、高血压、糖尿病、高脂血症、冠心病家族史、射血分数、住院期间药物应用及术后6个月药物应用比较,差异均无统计学意义( P>0.05)。3组患者病变部位、参考血管直径、血管狭窄程度、最小管腔直径比较,差异均无统计学意义(P>0.05)。治疗后6个月时,3组患者均未发生心源性猝死、心肌梗死,PCI组和延迟PCI组均未发生再次血运重建,仅药物治疗组出现2例(18.0%)再次血运重建。3组再发心绞痛率比较,差异无统计学意义(P=0.832)。结论在冠状动脉介入治疗中处理临界病变时,通过测定FFR值指导治疗,在短期内并未增加不良心血管事件,并可以更好地指导PCI治疗。
目的:探討血流儲備分數( FFR )在指導冠狀動脈臨界病變中的臨床療效及應用價值。方法選取2013年1—6月在新疆醫科大學附屬中醫醫院接受冠狀動脈造影( CAG)評估冠狀動脈管腔直徑狹窄為50%~70%的臨界病變,併接受FFR測量的患者43例,根據FFR值,以0.75為界值分組。FFR≥0.75者為延遲PCI組予以藥物治療;FFR<0.75者採用隨機數字錶法分為藥物治療組(阿司匹林、氯吡格雷、他汀類)和 PCI +藥物治療組( PCI組)。患者均于治療後6箇月時進行隨訪,觀察主要心血管不良事件( MACE)(心源性猝死、非緻死性心肌梗死、再次血運重建等)以及再髮心絞痛情況。結果根據FFR值,PCI組12例,藥物治療組11例,延遲PCI組20例。3組患者性彆、年齡、吸煙率、高血壓、糖尿病、高脂血癥、冠心病傢族史、射血分數、住院期間藥物應用及術後6箇月藥物應用比較,差異均無統計學意義( P>0.05)。3組患者病變部位、參攷血管直徑、血管狹窄程度、最小管腔直徑比較,差異均無統計學意義(P>0.05)。治療後6箇月時,3組患者均未髮生心源性猝死、心肌梗死,PCI組和延遲PCI組均未髮生再次血運重建,僅藥物治療組齣現2例(18.0%)再次血運重建。3組再髮心絞痛率比較,差異無統計學意義(P=0.832)。結論在冠狀動脈介入治療中處理臨界病變時,通過測定FFR值指導治療,在短期內併未增加不良心血管事件,併可以更好地指導PCI治療。
목적:탐토혈류저비분수( FFR )재지도관상동맥림계병변중적림상료효급응용개치。방법선취2013년1—6월재신강의과대학부속중의의원접수관상동맥조영( CAG)평고관상동맥관강직경협착위50%~70%적림계병변,병접수FFR측량적환자43례,근거FFR치,이0.75위계치분조。FFR≥0.75자위연지PCI조여이약물치료;FFR<0.75자채용수궤수자표법분위약물치료조(아사필림、록필격뢰、타정류)화 PCI +약물치료조( PCI조)。환자균우치료후6개월시진행수방,관찰주요심혈관불량사건( MACE)(심원성졸사、비치사성심기경사、재차혈운중건등)이급재발심교통정황。결과근거FFR치,PCI조12례,약물치료조11례,연지PCI조20례。3조환자성별、년령、흡연솔、고혈압、당뇨병、고지혈증、관심병가족사、사혈분수、주원기간약물응용급술후6개월약물응용비교,차이균무통계학의의( P>0.05)。3조환자병변부위、삼고혈관직경、혈관협착정도、최소관강직경비교,차이균무통계학의의(P>0.05)。치료후6개월시,3조환자균미발생심원성졸사、심기경사,PCI조화연지PCI조균미발생재차혈운중건,부약물치료조출현2례(18.0%)재차혈운중건。3조재발심교통솔비교,차이무통계학의의(P=0.832)。결론재관상동맥개입치료중처리림계병변시,통과측정FFR치지도치료,재단기내병미증가불양심혈관사건,병가이경호지지도PCI치료。
Objective To explore the clinical effects and application values of fractional flow reserve( FFR) in guid-ing coronary intervention for critical lesions. Methods 43 patients with coronary critical lesions received CAG evaluation and FFR in Xinjiang TCM Hospital from January to June 2013 were divided into groups according to FFR values( taking 0. 75 as di-viding value). The patients with FFR≥0. 75 were divided into defer PCI group( given drug treatment),the patients with FFR<0. 75 were divided randomly into groups drug treatment( DT group;given aspirin,clopidogrel,statins),PCI +DT group (PCI group). The patients were followed up in months 6 after treatment to observe the major adverse cardiac events(MACE) and recurrence of angina pectoris( AP). Results According to FFR values,there were 12 cases in PCI+DT group,11 in DT group,20 in defer PCI group. There was no significant difference in gender,age,smoking rate,hypertension,diabetes,hy-perlipidemia,the proportion of family history,ejection fraction,drug use during hospitalization or in months 6 after treatment a-mong 3 groups(P>0. 05);there was no difference in diseased region,reference diameter,angiostegnosis percentage,mini-mum lumen diameter(P>0. 05). In the follow-up in months 6 after treatment,no cardiac sudden death,myocardial infarc-tion occurred in 3 groups,there was no patient having revascularization in groups PCI+DT,defer PCI,but there were 2 cases (18. 0%)in DT group. There was no difference in rate of AP recurrence(P=0. 832). Conclusion In dealing critical le-sions in coronary intervention,FFR values do not increase MACE but can guide PCI treatment better.