血流储备分数在多支血管病变患者中指导经皮冠状动脉介入治疗疗效的荟萃分析

The meta-analysis of the value of fractional flow reserve guided percutaneous coronary intervention for patients with multivessel diseases

目的系统地评价血流储备分数(FFR)与其他方法在多支血管病变患者中指导经皮冠状动脉介入治疗(PIC)的疗效。方法利用关键词"血流储备分数或者FFR、经皮冠状动脉介入治疗或者PCI、多支血管病变"的中英文检索中文数据库中国知网(CNKI)、万方和维普中文科技期刊数据库以及英文数据库Pubmed、EMBASE和Web of science中关于FFR指导PCI治疗多支血管病变的随机对照实验的文献。按照Jadad评分标准对纳入文献进行质量评价,利用Stata10.0进行荟萃分析。结果共有7篇英文文献,累计实验组2 024人,对照组7 284人纳入统计分析。与其他治疗方式相比,FFR指导PCI治疗多支血管病变发生心肌梗死的风险显著降低(RR=0.72,P=0.008);虽然患者出现死亡和主要心血管不良事件的风险也降低,但差异无统计学意义。结论 FFR指导PCI治疗多支血管病变是一种有效的治疗手段,但其是否适用于中国人群仍需要进一步验证。

Objective To systematically evaluate the clinical outcomes of patients with multivessel diseases treated by fractional flow reserve （FFR） guided percutaneous coronary intervention（PCD or other forms of treatment. Methods Some keywords inclu- ding FFR or fractional flow reserve, percutaneous coronary intervention or PCI, multivessel coronary artery disease were used to search randomized control trails（RCT）,which compared outcomes of patients with multivessel disease treated by FFR guided PCI with other forms of treatment,in Chinese and English database including CNKI, VIP, Wanfang, Pubmed, EMBASE and the web of science. The quality of included studies was evaluated by Jadad quality score and all the data was analyzed by statal0.0. Results A total of 7 english literatures accumulating 2 024 cases in experimental group and 7 284 cases in control group were included in this study. Compared with other forms of treatment, patients with multivessel diseases treated by FFR-guided PCI had significantly low- er risk of myocardial infaretion（RR=0.72 ,P=0. 008）. Although the risk of death and major adverse cardiovascular events were al- so be reduced, there were no statistically significant difference. Conclusion FFR-guided PCI is an effective treatment for multivessel disease, but it is still needs further verification for the application in Chinese population.