朱贵家,刘洋洋,曹阳,陈琳,孙兑荣,董国,甘润韬,杨树森

• 1:哈尔滨医科大学附属第一医院心内一科

摘要(Abstract)：

目的通过测量血流储备分数(FFR),决定是否对不稳定型心绞痛多支血管病变患者经皮冠状动脉介入治疗(PCI)术中非罪犯中度狭窄血管行介入治疗,并观察临床转归。方法本研究入选不稳定型心绞痛多支血管病变患者,首先对已明确的罪犯血管行PCI治疗后,针对非罪犯中度狭窄血管按照单双号分为对照组(非支架组)和观察组(FFR指导下行PCI组)。其中,观察组FFR<0.8的患者对中度狭窄血管行PCI治疗,术后再次行FFR检测,确保FFR≥0.95。观察终点事件为全因死亡、非致死性心肌梗死、再次血运重建发生率以及心绞痛临床表现。结果共纳入71例患者,对照组35例;观察组36例,其中FFR≥0.8的患者23例,FFR<0.8的患者13例。两组患者无主要终点事件和再次血运重建生存率分别比较,差异均有统计学意义(P<0.05);无全因死亡与非致死性心肌梗死生存率分别比较,差异均无统计学意义。针对靶血管不良事件的统计学分析显示,两组再次血运重建(观察组5.6%,对照组31.4%)及非致死性心肌梗死(观察组5.6%,对照组28.6%)发生率分别比较,差异均有统计学意义(P<0.05)。结论不稳定型心绞痛患者中,使用压力导丝测出的FFR值来决定是否对非罪犯中度病变进行血运重建是安全的。FFR结合冠状动脉造影指导PCI治疗较单纯冠状动脉造影指导PCI的不良事件发生率显著减少,尤其在再次血运重建方面,并且心绞痛临床表现显著缓解。

关键词(KeyWords)： 不稳定型心绞痛;血流储备分数;非罪犯中度狭窄血管;经皮冠状动脉介入治疗;再次血运重建

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 朱贵家,刘洋洋,曹阳,陈琳,孙兑荣,董国,甘润韬,杨树森

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