姚道阔,陈晖,李东宝,梁思文,周力,马国栋,刘锐锋,崔贺贺

• 1:首都医科大学附属北京友谊医院心血管中心

摘要(Abstract)：

目的探讨冠心病临界病变冠状动脉血流储备(CFR)降低的临床与冠状动脉造影特点。方法入选北京友谊医院行冠状动脉造影的冠心病临界病变患者,行冠状动脉生理学检测,包括血流储备分数(FFR)、CFR、微循环阻力指数(IMR)测定。将FFR> 0.8的患者根据CFR <2与CFR≥2分为两组,比较两组患者临床与冠状动脉造影特点。对FFR> 0.8且CFR <2的患者,根据IMR≥23与IMR <23再分为两个亚组,比较两亚组患者临床与冠状动脉造影特点。结果研究从完成冠状动脉内生理学检测的89例冠状动脉临界病变中共入选FFR> 0.8的患者52例,其中CFR <2组19例(36.5%)。CFR <2组高血压病(89.5%比42.4%,P <0.001)、糖尿病(52.6%比18.2%,P=0.011)、吸烟(36.8%比9.0%,P=0.031)和右冠状动脉比例(57.9%比15.2%,P=0.002)、IMR[(26.7±3.7)比(17.3±5.0),P <0.001]明显高于CFR≥2组。IMR≥23亚组血清C反应蛋白[(8.37±1.67)mg/L比(3.85±1.01)mg/L,P <0.001]、中性粒细胞与淋巴细胞比值[(3.94±0.87)比(2.04±0.43),P <0.001]明显高于IMR <23亚组。结论冠状动脉临界病变CFR降低更常见于有高血压病、糖尿病、吸烟史的患者,右冠状动脉评估时更常见、易合并IMR升高。

关键词(KeyWords)： 冠心病;临界病变;冠状动脉血流储备;血流储备分数;微循环阻力

Abstract:

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基金项目(Foundation): 首都医科大学基础与临床合作研究基金(16JL19)

作者(Author): 姚道阔,陈晖,李东宝,梁思文,周力,马国栋,刘锐锋,崔贺贺

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