耿亮,袁圆,万青,王兴旭,游洁芸,俞帅,韦苇,李纪明,高力明,汪云开,郭蔚,黄瑛,张奇

• 1:同济大学附属东方医院心脏内科

摘要(Abstract)：

目的探讨冠状动脉临界病变血管内超声(IVUS)检查参数与定量血流分数(QFR的相关性。方法前瞻性连续入选2018年9月至2019年9月于同济大学附属东方医院接受QFR和IVUS检查的116例患者(117处冠状动脉临界病变)。根据QFR评估结果,将患者分为QFR≤0.80组(25处病变)和QFR>0.80组(92处病变),比较两组IVUS检查参数的差异。应用Poisson线性相关性分析以及受试者工作特征(ROC)曲线评估IVUS与QFR的相关性,应用logistic多元回归分析QFR≤0.80的预测因素。结果 IVUS检查发现,QFR≤0.80组最小管腔面积(MLA)[(3.1±0.8)mm2比(3.6±1.1)mm2,P=0.040]、最小管腔直径(MLD)[(1.8±0.3)mm比(2.0±0.3)mm,P=0.012]显著小于QFR>0.80组,而斑块负荷[(73.5±5.6)%比(68.0±8.4)%,P=0.002]、面积狭窄率[(69.8±8.8)%比(63.8±9.8)%,P=0.007]、斑块偏心指数[(0.83±0.12)比(0.73±0.19),P=0.008]及回声消减斑块比例(52.0%比23.9%,P=0.003)显著高于QFR>0.80组,差异均有统计学意义。Poisson线性相关分析显示,MLA(r=0.259,P=0.005)、MLD(r=0.300,P=0.001)与QFR正相关,而斑块负荷(r=–0.357,P<0.001)以及斑块偏心指数(r=–0.247,P=0.008)与QFR负相关。logistic多因素回归分析表明斑块负荷>70%(OR 4.531,95%CI 1.443～14.222,P=0.010)和斑块偏心指数(OR 1.066,95%CI 1.014～1.121,P=0.012)为QFR≤0.80的独立预测因素。结论冠状动脉临界病变IVUS检查结果中斑块负荷>70%以及斑块偏心指数是QFR≤0.80的独立预测因子。

关键词(KeyWords)： 冠状动脉疾病;临界病变;定量血流分数;血管内超声

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金（81870202）;; 上海市浦东新区学科带头人计划（PWRD2018-06）

作者(Author): 耿亮,袁圆,万青,王兴旭,游洁芸,俞帅,韦苇,李纪明,高力明,汪云开,郭蔚,黄瑛,张奇

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