血流储备分数对伴有冠脉临界病变不稳定型心绞痛患者治疗的指导作用
发布时间：2018-09-11 09:10
【摘要】：目的探讨血流储备分数(FFR)在存在冠状动脉(简称冠脉)临界病变不稳定型心绞痛患者治疗中的应用价值。方法选取不稳定型心绞痛患者174例,均经冠脉造影(CAG)检查证实至少一支主要冠脉存在临界病变(50%~70%狭窄)。随机分为观察组59例(病变血管84支)、对照组115例(病变血管163支)。对照组给予规范药物治疗。观察组入院后进行FFR检测,其中狭窄冠脉FFR0.75者29例,全部进行经皮冠脉介入治疗(PCI)置入支架;FFR在0.75~0.80者9例,PCI置入支架5例,其余行药物保守治疗;FFR0.8者21例,行药物保守治疗。分别统计两组随访1、6、12个月时CCS心绞痛分级;统计12个月内主要心血管不良事件(MACE)发生情况,MACE包括靶血管再次血运重建、非致死性心肌梗死、心源性死亡。结果两组治疗前加拿大心血管学会(CCS)心绞痛分级均以Ⅲ、Ⅳ级为主(P均0.05);随访1、6、12个月时,两组均未出现Ⅳ级心绞痛发作,观察组Ⅲ级心绞痛发生率均低于对照组(P均0.05)。随访12个月内观察组9例(15.3%)发生MACE,包括非致死性心肌梗死5例、再次血运重建4例;对照组40例(34.8%)发生MACE,包括心源性死亡1例、非致死性心肌梗死20例、再次血运重建19例。观察组再次血运重建发生率及总MACE发生率均低于对照组(P均0.05)。结论对于存在冠脉临界病变的不稳定型心绞痛患者,在FFR指导下选择PCI或药物治疗有助于减少MACE发生,缓解心绞痛发作。
[Abstract]:Objective to investigate the value of flow reserve fraction (FFR) in the treatment of unstable angina pectoris with critical lesion of coronary artery. Methods A total of 174 patients with unstable angina pectoris were examined by coronary angiography (CAG). At least one major coronary artery had a critical lesion (50% stenosis). They were randomly divided into observation group (n = 59) and control group (n = 115). The control group was given standard drug therapy. In the observation group, FFR was detected after admission, including 29 cases of FFR0.75 with coronary stenosis, 9 cases of which were treated with percutaneous coronary intervention (PCI) at 0.75 ~ 0.80, 5 cases with stenting, 21 cases were treated with drug conservative therapy, and 21 cases were treated with drug conservative therapy. The CCS angina pectoris grade of the two groups were analyzed at 1 and 12 months, and the occurrence of (MACE) in the main cardiovascular adverse events within 12 months was analyzed. Mace included re-revascularization of the target vessels, non-fatal myocardial infarction and cardiac death. Results before treatment, the (CCS) angina pectoris grades of the Canadian Cardiovascular Society were mainly grade 鈪，
本文编号：2236256
[Abstract]:Objective to investigate the value of flow reserve fraction (FFR) in the treatment of unstable angina pectoris with critical lesion of coronary artery. Methods A total of 174 patients with unstable angina pectoris were examined by coronary angiography (CAG). At least one major coronary artery had a critical lesion (50% stenosis). They were randomly divided into observation group (n = 59) and control group (n = 115). The control group was given standard drug therapy. In the observation group, FFR was detected after admission, including 29 cases of FFR0.75 with coronary stenosis, 9 cases of which were treated with percutaneous coronary intervention (PCI) at 0.75 ~ 0.80, 5 cases with stenting, 21 cases were treated with drug conservative therapy, and 21 cases were treated with drug conservative therapy. The CCS angina pectoris grade of the two groups were analyzed at 1 and 12 months, and the occurrence of (MACE) in the main cardiovascular adverse events within 12 months was analyzed. Mace included re-revascularization of the target vessels, non-fatal myocardial infarction and cardiac death. Results before treatment, the (CCS) angina pectoris grades of the Canadian Cardiovascular Society were mainly grade 鈪，
本文编号：2236256
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