【摘要】 目的探讨血流储备分数(FFR)检查在冠状动脉(冠脉)临界病变介入治疗中的应用价值。方法选择冠脉造影结果证实为冠脉临界病变(狭窄40%~70%)的98例患者,均接受FFR检查,对FFR<0.8的28例患者(介入组)进行冠脉介入手术(PCI)治疗,术后常规肝素抗凝治疗24 h,之后进行双联抗血小板聚集治疗。对FFR≥0.8的70例患者(药物组)则进行强化药物治疗,包括阿司匹林、他汀、ACEI/ARB、β受体阻滞剂、硝酸酯类药物。患者均随访1年。观察心绞痛次数(每周);冠脉造影结果;主要不良心脏事件(死亡,心肌梗死,靶血管运重建)。进行运动平板试验,观察心电图ST段变化情况。结果介入组治疗前心绞痛发生次数明显高于药物组(P<0.05)。两组患者1年后心脏主要不良事件、心绞痛发生人次、心绞痛分级及心电图ST段变化比较均无统计学差异。结论 FFR检查能有效指导冠脉临界病变介入治疗。更多还原

【Abstract】 Objective To investigate the application value of fractional flow reserve( FFR) examination in guidance of interventional treatment of coronary intermediate lesions. Methods We chose 98 patients with the results of coronary angiography as the critical lesions( stenosis 40%-70%). All the patients underwent FFR examination. Twenty-eight patients whose FFR was less than 0. 8( the intervention group) received percutaneous coronary intervention( PCI) operation and routine postoperative anticoagulation with heparin 24 h,followed by dual antiplatelet treatment. Seventy patients whose FFR was more than or equal to 0. 8( the drug group) underwent strengthening drug therapy,including aspirin,statins,ACEI / ARB,beta blockers and nitrates. The patients were followed up for 1 year. The number of angina pectoris( once week),coronary angiography and major adverse cardiac events( death,MI,TVR) were observed. Then,we did the exercise treadmill test to observe the changes of ECG ST segment. Results The angina frequency in the interventionthe number of patients who had angina,angina pectoris grade and exercise group before treatment was significantly higher than that of the drug group( P < 0. 05). The major adverse cardiac events,the number of patients who had angina,angina pectoris grade and the changes of ECG ST segment showed no significant difference between the two groups. Conclusion FFR is an effective method to guide the critical lesions of coronary artery interventional therapy.更多还原