心肌血流储备分数指导ST段抬高心肌梗死患者择期经皮冠状动脉介入的临床评价

Clinical evaluation of application of myocardial fractional flow reserve on elective percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

目的探讨心肌血流储备分数(FFRmyo)对ST段抬高心肌梗死(STEMI)患者择期经皮冠状动脉介入治疗(PCI)的意义。方法 STEMI行早期溶栓治疗或血栓自溶择期冠状动脉造影(CAG)的患者75例,其中FFRmyo<0.75者33例,行PCI治疗21例(A组),拒绝行PCI治疗12例(B组),FFRmyo≥0.75者42例(C组)。记录患者一般临床资料,比较各组罪犯血管特点及临床事件发生情况。结果各组患者一般临床资料无统计学差异。随访一年,患者临床事件包括死亡、心肌梗死、靶血管血运重建及再住院的总发生率在A组及C组均显著低于B组(分别为P<0.05)。结论 FFRmyo测定对STEMI患者制定合理的治疗策略具有参考价值。

Objective To explore the application of myocardial fractional flow reserve （FFRmyo） on elective percutaneous coronary intervention （PCI） in patients with ST-segment elevation myocardial infarction （STEMI）. Methods In all, 75 STEMI patients undergoing early thrombolysis treatment or spontaneous recanalization with elective PCI were recruited in this study. There were 33 patients with FFRmyo〈0.75, 21 of whom received PCI treatment （Group A） and the other 12 patients did not have PCI treatment （Group B）. 42 patients had FFRmyo≥0.75 （Group C）. Basic clinical characteristics, culprit vessel features and the clinical events were compared in each group. Results There was no statistical difference of the basic clinical characteristics in each group （P〉0.05）. Fellowed one year, the total incidence of the clinical events including death, myocardial infarction, target vessel revascularization and rehospitalization was significantly lower in both Group A and Group C compared with Group B （P〈0.05, respectively）. Conclusion FFRmyo detection has a reference value on the establishment of treatment strategies for patients with STEMI.