山东医药
山東醫藥
산동의약
Shandong Medical Journal
2015年
38期
1-3
,共3页
宋光远%刘庆荣%张丽华%丁诚%杨跃进%徐波%乔树宾%唐熠达%吴永健
宋光遠%劉慶榮%張麗華%丁誠%楊躍進%徐波%喬樹賓%唐熠達%吳永健
송광원%류경영%장려화%정성%양약진%서파%교수빈%당습체%오영건
冠心病%介入治疗%冠状动脉内压力导丝技术%瞬时无波形比值%血流储备分数
冠心病%介入治療%冠狀動脈內壓力導絲技術%瞬時無波形比值%血流儲備分數
관심병%개입치료%관상동맥내압력도사기술%순시무파형비치%혈류저비분수
coronary disease%interventional therapy%intracoronary pressure wire%instantaneous wave-free ratio%fractional flow reserve
目的：探讨用冠状动脉内压力导丝技术测定瞬时无波形比值（iFR）联合血流储备分数（FFR）指导冠心病患者经皮冠状动脉介入治疗（PCI）的效果。方法选取冠状动脉造影提示狭窄50％～70％的冠心病患者20例，用冠状动脉内压力导丝技术测定病变血管采集iFR，给予硝酸甘油后在3 min内高速注射扩血管药物腺苷三磷酸（ATP）140μg／（kg· min），采集高速注射ATP后的iFR（iFRATP ）、FFR。计算联合应用iFR和FFR指导PCI与单纯FFR指导PCI的准确性、灵敏度、特异度、阳性预测值、阴性预测值，计算联合应用iFR和FFR指导PCI避免使用ATP患者的比例。结果本组病变血管iFR为0．9±0．1，iFRATP为0．7±0．2，两者相比P＜0．001。 iFR、iFRATP与FFR呈正相关，r分别为0．68、0．91，P均＜0．001。联合应用iFR、FFR相对于单用FFR指导PCI的准确率为91．3％（21／23）、敏感度为92．3％（12／13）、特异性为90．0％（9／10）、阳性预测值为92．3％（12／13）、阴性预测值为90．0％（9／10），并可以避免60．0％（12／20）的患者应用ATP。结论联合应用iFR和FFR指导PCI效果满意，且可以减少患者静脉应用ATP。
目的：探討用冠狀動脈內壓力導絲技術測定瞬時無波形比值（iFR）聯閤血流儲備分數（FFR）指導冠心病患者經皮冠狀動脈介入治療（PCI）的效果。方法選取冠狀動脈造影提示狹窄50％～70％的冠心病患者20例，用冠狀動脈內壓力導絲技術測定病變血管採集iFR，給予硝痠甘油後在3 min內高速註射擴血管藥物腺苷三燐痠（ATP）140μg／（kg· min），採集高速註射ATP後的iFR（iFRATP ）、FFR。計算聯閤應用iFR和FFR指導PCI與單純FFR指導PCI的準確性、靈敏度、特異度、暘性預測值、陰性預測值，計算聯閤應用iFR和FFR指導PCI避免使用ATP患者的比例。結果本組病變血管iFR為0．9±0．1，iFRATP為0．7±0．2，兩者相比P＜0．001。 iFR、iFRATP與FFR呈正相關，r分彆為0．68、0．91，P均＜0．001。聯閤應用iFR、FFR相對于單用FFR指導PCI的準確率為91．3％（21／23）、敏感度為92．3％（12／13）、特異性為90．0％（9／10）、暘性預測值為92．3％（12／13）、陰性預測值為90．0％（9／10），併可以避免60．0％（12／20）的患者應用ATP。結論聯閤應用iFR和FFR指導PCI效果滿意，且可以減少患者靜脈應用ATP。
목적：탐토용관상동맥내압력도사기술측정순시무파형비치（iFR）연합혈류저비분수（FFR）지도관심병환자경피관상동맥개입치료（PCI）적효과。방법선취관상동맥조영제시협착50％～70％적관심병환자20례，용관상동맥내압력도사기술측정병변혈관채집iFR，급여초산감유후재3 min내고속주사확혈관약물선감삼린산（ATP）140μg／（kg· min），채집고속주사ATP후적iFR（iFRATP ）、FFR。계산연합응용iFR화FFR지도PCI여단순FFR지도PCI적준학성、령민도、특이도、양성예측치、음성예측치，계산연합응용iFR화FFR지도PCI피면사용ATP환자적비례。결과본조병변혈관iFR위0．9±0．1，iFRATP위0．7±0．2，량자상비P＜0．001。 iFR、iFRATP여FFR정정상관，r분별위0．68、0．91，P균＜0．001。연합응용iFR、FFR상대우단용FFR지도PCI적준학솔위91．3％（21／23）、민감도위92．3％（12／13）、특이성위90．0％（9／10）、양성예측치위92．3％（12／13）、음성예측치위90．0％（9／10），병가이피면60．0％（12／20）적환자응용ATP。결론연합응용iFR화FFR지도PCI효과만의，차가이감소환자정맥응용ATP。
Objective To investigate the efficacy of using instantaneous wave-free ratio ( iFR) detected by intracoro-nary pressure wire combined with fractional flow reserve ( FFR) in guiding percutaneous coronary intervention ( PCI) on patients with coronary disease .Methods Twenty patients with coronary disease whose coronary arteriography showed that stenosis diameter was 50%-70%were included .The intracoronary pressure wire was used to detect the pathological ves-sels to collect iFR, which was treated with nitroglycerin and adenosine triphosphate (ATP) 140 μg/(kg· min) was added within 1-3 mins.FFR and iFR(iFRATP) which was treated with ATP were measured.The accuracy, sensitivity, specifici-ty, positive predictive value and negative predictive value were calculated in using iFR and PCI or only FFR in guiding PCI, and then we calculated the proportion of avoiding using ATP during the guidance of combined using of iFR and FFR . Results The iFR of pathological vessels was 0.9 ±0.1, and iFRATP was 0.7 ±0.2 (P<0.01).iFR and iFRATP was related with FFR (r=0.68, 0.91;all P<0.001).The accuracy was 91.3%(21/23), the sensitivity was 91.3%(12/13), specificity was 90.0%(9/10), the positive predictive value was 92.3%(12/13) and the negative predictive value was 90.0%(9/10) in the combined application of iFR and FFR during PCI as compared with the only FFR .Meanwhile, it avoided 60.0%of the patients (12/20) receiving ATP.Conclusion The combination of iFR and FFR in guiding PCI has good efficacy , and it can reduce the intravenous ATP .
