张明多,田晋帆,张东凤,张闽,葛长江,宋现涛

• 1:首都医科大学附属北京安贞医院心血管内科

摘要(Abstract)：

目的 分析瑞加诺生对比腺苷在冠心病患者中测量血流储备分数（FFR）的有效性和安全性。方法 连续前瞻性入选2023年8月至2024年7月于首都医科大学附属北京安贞医院住院行冠状动脉造影的30例患者。自身前后测量的方法对照测量FFR，采用同一受试者设计进行测量。瑞加诺生与腺苷均通过标准化方式给药，并详细记录FFR值、血流动力学参数、心电图和不良事件等。结果 30例患者，平均年龄（60.4±6.8）岁。按照自身前后对照分为瑞加诺生组与腺苷组。瑞加诺生组和腺苷组的FFR值分别为（0.71±0.12）和（0.76±0.11），差异无统计学意义（P>0.05）。与腺苷组相比，瑞加诺生组的FFR测量准确度90.0%，敏感度95.0%，特异度80.0%，阳性预测值90.5%，阴性预测值88.8%，受试者工作特征曲线下面积（AUC）为0.890(P<0.001)，有良好的诊断性能。一致性分析的相关系数r=0.712(P<0.001)，进一步提示两者具有良好的一致性。瑞加诺生组较腺苷组起效时间更快[（30±20）s比（60±30）s,P<0.001]，总体不良反应发生率显著更低[36.7%(11/30)比63.3%(19/30),P<0.001]。瑞加诺生组严重胸闷/呼吸困难（P=0.012）、严重房室传导阻滞（P=0.047）及明显血压下降（P=0.038）的发生率均显著低于腺苷组，差异均有统计学意义；两组间心悸及其他严重不良反应发生率比较，差异均无统计学意义（均P>0.05）。结论 瑞加诺生是腺苷的一个可接受的替代品，用于中等程度冠状动脉狭窄的侵入性FFR评估。

关键词(KeyWords)： 瑞加诺生;腺苷;血流储备分数;冠状动脉疾病

Abstract:

Keywords:

基金项目(Foundation): 北京市医院管理中心“登峰”计划专项项目（DFL20220603）;; 北京市卫生部高层次公共卫生技术人才项目（领军人才-02-01）

作者(Author): 张明多,田晋帆,张东凤,张闽,葛长江,宋现涛

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