血流储备分数对并发糖耐量减低的冠状动脉粥样硬化性心脏病临界病变介入术后心脏不良事件的评价

目的探讨压力导丝测定的血流储备分数(FFR)对并发糖耐量减低(IGT)的冠状动脉粥样硬化性心脏病(CAHD)患者临界冠状动脉病变介入治疗术后发生主要心脏不良事件的预测价值。方法 58例临床诊断为CAHD并发的CAHD临界病变患者分为FFR指导治疗组(FFR组,n=28)和根据术者经验指导治疗组(对照组,n=30)。观察2组患者支架植入例数及支架植入数量,同时观察2组患者在住院期间和随访期间发生典型心绞痛、非致死性心肌梗死、心源性病死和靶血管重建等主要心脏不良事件的发生率。结果 FFR组共有12例14处病变行冠状动脉介入术治疗,置入支架16枚,治疗率43.8%;对照组共有39处临界狭窄病变,有17例21处病变行冠状动脉介入术治疗,置入支架32枚,治疗率53.8%。FFR组患者治疗率、植入支架数量低于对照组,差异有统计学意义(P<0.05)。FFR组患者术后典型心绞痛、非致死性心肌梗死和靶血管重建等主要心脏不良事件的发生率低于对照组,差异有统计学意义(P<0.05)。结论 FFR可安全地指导并发IGT的临界冠状动脉病变的介入治疗,由FFR指导植入的支架数量显著减少,心脏不良事件发生率显著降低

Predictive value of fractional flow reserve on major adverse cardiac event after interventional therapy in patients with coronary artery intermediate lesions combined with impaired glucose tolerance

Objective To investigate the predictive value of fractional flow reserve(FFR) which measured by pressure wire on the major adverse cardiac event after interventional therapy in patients with coronary artery intermediate lesions combined with impaired glucose tolerance.Methods Fifty-eight patients with coronary artery intermediate lesions combined with impaired glucose tolerance were divided into FFR group(n=28) which were treated under guidance of FFR and control group(n=30) which were treated according to the operator experience.The number of patients who were given stent implantation and the number of stent implantation were compared between the two groups.The incidence of typical angina,nonfatal myocardial infarction,cardiac death and target-vessel revascularization and other major adverse cardiac events in hospital and follow up periods were observed between the two groups.Results Twelve patients(with 14 lesions) underwent interventional treatment,and 16 stents were implanted in FFR group;the treatment rate was 43.8%.Seventeen patients(with 21 lesions) underwent interventional treatment,and 32 stents were implanted in control group;the treatment rate was 53.8%.The treatment rates,number of stent implantation of FFR group were significantly lower than those of the control group(P<0.05).The incidence of typical angina,nonfatal myocardial infarction,and target-vessel revascularization in FFR group were significantly lower than those in the control group(P<0.05).Conclusion The treatment under the guidance of the FFR in patients with coronary critical lesion combined with impaired glucose tolerance is safe.The number of stent implantation is less and the incidence of major adverse cardiac events is lower under the guidance of FFR.