张瑞涛,谢鹏昕,田振宇,米琳,周继升,吴本真,何立芸,郭丽君

• 1:北京大学第三医院心内科血管医学研究所血管稳态与重构全国重点实验室国家卫生健康委心血管分子生物学与调节肽重点实验室心血管受体研究北京市重点实验室

摘要(Abstract)：

目的 探讨血流储备分数（FFR）和定量血流分数（QFR）诊断一致性以及影响二者诊断一致性病变的特征。方法 回顾分析2019年1月至2021年12月就诊于北京大学第三医院心内科冠状动脉造影狭窄30%～70%并接受FFR检测的非急性心肌梗死患者。以FFR或QFR≤0.80为阳性（+），>0.80为阴性（–），将患者分为：诊断一致组（FFR+/QFR+和FFR–/QFR–）、诊断不一致组（FFR+/QFR–和FFR–/QFR+），以FFR为金标准，分析QFR的诊断价值，比较各组之间临床特征及病变特征之间的差异。结果 共纳入236例患者，平均年龄（64.48±9.63）岁，男67.8%。QFR和FFR诊断一致性为184例（78.0%）,Person相关系数为0.557(P<0.001)。在FFR+患者中，诊断不一致组中最小管腔直径更大[（1.56±0.34）mm比（1.39±0.31）mm,P=0.019]、病变长度更短[（21.37±11.73）mm比（36.86±18.09）mm,P<0.001]、冠状动脉造影衍生的微循环阻力指数（AMR）更高[（277.50±28.87）mmHg·s/m比（178.02±49.13）mmHg·s/m,P <0.001]。通过二元Logistic回归分析提示AMR[OR0.93,95%CI0.88～0.99,P=0.030]和病变长度[OR 1.27,95%CI 1.01～1.60,P=0.045]是诊断不一致独立预测因子。在FFR–组中，诊断不一致组的病变长度更长[（33.08±16.05）mm比（21.40±13.36）mm,P=0.020],AMR[(169.66±24.01)mmHg·s/m比（265.95±44.78）mmHg·s/m,P<0.001）和低密度脂蛋白胆固醇[1.57(1.10,1.97)mmol/L比2.15(1.79,2.74)mmol/L,P=0.031]更低。二元Logistic回归分析未发现具有统计学意义变量。结论 QFR和FFR具有较高的诊断一致性。在FFR+患者中，AMR和病变长度可能影响QFR和FFR的诊断一致性。

关键词(KeyWords)： 血流储备分数;定量血流分数;冠状动脉功能学;冠状动脉造影衍生的微循环阻力指数

Abstract:

Keywords:

基金项目(Foundation): 中国心馨心血管健康基金会冠状动脉微血管疾病创新基金项目（2018-CCA-CMVD-08）

作者(Author): 张瑞涛,谢鹏昕,田振宇,米琳,周继升,吴本真,何立芸,郭丽君

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