【摘要】：目的探討血流儲備分?jǐn)?shù)(FFR)在存在冠狀動脈(簡稱冠脈)臨界病變不穩(wěn)定型心絞痛患者治療中的應(yīng)用價值。方法選取不穩(wěn)定型心絞痛患者174例,均經(jīng)冠脈造影(CAG)檢查證實至少一支主要冠脈存在臨界病變(50%~70%狹窄)。隨機(jī)分為觀察組59例(病變血管84支)、對照組115例(病變血管163支)。對照組給予規(guī)范藥物治療。觀察組入院后進(jìn)行FFR檢測,其中狹窄冠脈FFR0.75者29例,全部進(jìn)行經(jīng)皮冠脈介入治療(PCI)置入支架;FFR在0.75~0.80者9例,PCI置入支架5例,其余行藥物保守治療;FFR0.8者21例,行藥物保守治療。分別統(tǒng)計兩組隨訪1、6、12個月時CCS心絞痛分級;統(tǒng)計12個月內(nèi)主要心血管不良事件(MACE)發(fā)生情況,MACE包括靶血管再次血運重建、非致死性心肌梗死、心源性死亡。結(jié)果兩組治療前加拿大心血管學(xué)會(CCS)心絞痛分級均以Ⅲ、Ⅳ級為主(P均0.05);隨訪1、6、12個月時,兩組均未出現(xiàn)Ⅳ級心絞痛發(fā)作,觀察組Ⅲ級心絞痛發(fā)生率均低于對照組(P均0.05)。隨訪12個月內(nèi)觀察組9例(15.3%)發(fā)生MACE,包括非致死性心肌梗死5例、再次血運重建4例;對照組40例(34.8%)發(fā)生MACE,包括心源性死亡1例、非致死性心肌梗死20例、再次血運重建19例。觀察組再次血運重建發(fā)生率及總MACE發(fā)生率均低于對照組(P均0.05)。結(jié)論對于存在冠脈臨界病變的不穩(wěn)定型心絞痛患者,在FFR指導(dǎo)下選擇PCI或藥物治療有助于減少MACE發(fā)生,緩解心絞痛發(fā)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，

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