CAJ | 학술논문

目的：探讨冠状动脉造影联合血流储备分数（ FFR）在冠心病临界病变介入治疗中的指导作用。方法选取2012年4月—2013年3月在新疆生产建设兵团医院心血管内科就诊且接受冠状动脉造影的冠心病临界病变患者79例。根据是否行FFR，将其分为对照组（n＝29）和试验组（n＝50）。对照组参照《2006欧洲心脏病协会稳定型心绞痛诊治指南》，决定是否进行经皮冠状动脉介入治疗（ PCI）术；试验组患者在行冠状动脉造影的同时行FFR测定，根据FFR决定是否进行PCI术。收集并比较两组患者基线资料、术中所见血管病变数目、1年后主要心血管不良事件（MACE）发生率。结果两组性别、平均年龄、吸烟史、糖尿病史、高血压史、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（ HDL－C）、低密度脂蛋白胆固醇（ LDL－C）、随机血糖、左室射血分数比较，差异均无统计学意义（P＞0.05）；两组左冠状动脉前降支（LAD）、左冠状动脉回旋支（LCX）、右冠状动脉（RCA）中的血管病变数目比较，差异均无统计学意义（ P＞0.05）；术后1年随访时，两组再次血运重建、急性心肌梗死、复发心绞痛发生率比较，差异均有统计学意义（ P＜0.05）。结论采用冠状动脉造影联合FFR指导介入治疗，可以降低冠心病临界病变患者的MACE发生率，临床效果较好。
목적：탐토관상동맥조영연합혈류저비분수（ FFR）재관심병림계병변개입치료중적지도작용。방법선취2012년4월—2013년3월재신강생산건설병단의원심혈관내과취진차접수관상동맥조영적관심병림계병변환자79례。근거시부행FFR，장기분위대조조（n＝29）화시험조（n＝50）。대조조삼조《2006구주심장병협회은정형심교통진치지남》，결정시부진행경피관상동맥개입치료（ PCI）술；시험조환자재행관상동맥조영적동시행FFR측정，근거FFR결정시부진행PCI술。수집병비교량조환자기선자료、술중소견혈관병변수목、1년후주요심혈관불량사건（MACE）발생솔。결과량조성별、평균년령、흡연사、당뇨병사、고혈압사、총담고순（TC）、삼선감유（TG）、고밀도지단백담고순（ HDL－C）、저밀도지단백담고순（ LDL－C）、수궤혈당、좌실사혈분수비교，차이균무통계학의의（P＞0.05）；량조좌관상동맥전강지（LAD）、좌관상동맥회선지（LCX）、우관상동맥（RCA）중적혈관병변수목비교，차이균무통계학의의（ P＞0.05）；술후1년수방시，량조재차혈운중건、급성심기경사、복발심교통발생솔비교，차이균유통계학의의（ P＜0.05）。결론채용관상동맥조영연합FFR지도개입치료，가이강저관심병림계병변환자적MACE발생솔，림상효과교호。
Objective To investigate the significance of the guidance of coronary angiography combined with fractional flow reserve ( FFR) in the treatment of coronary borderline lesion.Methods We enrolled 79 patients with coronary borderline lesion who received treatment and coronary arteriography in Xinjiang Production and Construction Corps Hospital from April 2012 to March 2013.According to whether FFR was undertaken , the patients were divided into two groups: control group ( n=29 ) and trial group (n=50) .According to the 2006 European Society of Cardiology Guideline for the Management of Stable Angina Pectoris, percutaneous coronary intervention ( PCI) was decided to conduct or not on control group; the trial group received coronary artery angiography combined with FFR measurement , and PCI was decided to conduct or not based on FFR results.Comparison was made between the two groups in baseline data , the number of vascular lesions seen in surgery and the incidence of major adverse cardiovascular events ( MACE) one year after surgery.Results The two groups were not significantly different (P>0.05) in gender, average age, smoking history, medical history of diabetes mellitus, history of hypertension, TC, TG, HDL-C, LDL-C, random blood sugar and left ventricular ejection fraction ( LVEF) .The two groups were not significantly different ( P >0.05 ) in the numbers of lesion vessels in left anterior descending coronary artery ( LAD ) , left circumflex coronary artery (LCX) and right coronary artery (RCA); one year after surgery, the two groups were significantly different ( P<0.05 ) in the incidence rates of revascularization , acute myocardial infarction and the recurrence of angina one year after surgery.Conclusion Coronary arteriography combined with FFR can reduce the MACE incidence of patients with coronary borderline lesion.