影响冠状动脉左前降支近段临界病变血流储备分数的相关因素分析The analysis of angiographic characteristics and values of fractional flow reserve on intermediate lesion of proximal left anterior descending coronary artery
张薇,王志强,周志明,杨士伟,贾德安,韩红亚,周玉杰
摘要(Abstract):
目的探讨可能对冠状动脉左前降支近段临界病变血流储备分数(FFR)产生影响的因素。方法纳入2017年9月至2020年1月首都医科大学附属北京安贞医院167例冠状动脉左前降支近段临界病变的患者,行左前降支FFR检查,根据FFR值分为FFR≥0.75组(105例)及FFR<0.75组(62例),比较两组患者相关临床指标的差异,探讨FFR值与病变狭窄程度之间的关系。进行logistic多因素回归分析与FFR值相关的因素。结果两组患者性别、年龄、吸烟史、合并高血压病、合并糖尿病、体重指数、左心室射血分数、最小管腔直径、直径狭窄率、空腹血糖、总胆固醇、高密度脂蛋白胆固醇以及糖化血红蛋白水平等比较,差异均无统计学意义(均P>0.05);FFR<0.75组病变长度[(20.17±7.42)mm比(16.98±6.01)mm,P=0.045]及分支血管积分[(3.36±1.38)分比(2.71±1.04)分,P=0.023]显著大于FFR≥0.75组,差异有统计学意义。Pearson相关分析显示,FFR值与直径狭窄率无相关关系(r=0.371,P=0.067)。logistic多因素回归分析显示,病变长度(OR 2.197,95%CI 1.608~3.372,P=0.017)、分支血管积分(OR 2.101,95%CI 1.079~3.035,P=0.020)与FFR<0.75相关。结论左前降支近段临界病变冠状动脉狭窄的病变长度及病变以远的分支血管积分可能对FFR值产生影响。
关键词(KeyWords): 冠状动脉;临界病变;血流储备分数
基金项目(Foundation): 国家重点研发计划“精准医学研究”重点专项(2017YFC0908800);; 北京市医院管理局“登峰”计划专项(DFL20150601);北京市医院管理局“使命”计划专项(SML20180601);; 北京市卫生健康委员会科技创新中心建设项目(PXM2019_026272_000006、PXM2019_026272_000005)
作者(Author): 张薇,王志强,周志明,杨士伟,贾德安,韩红亚,周玉杰
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