心肌血流储备分数指导下短支架在冠脉长病变中的临床应用研究

Clinical Application Study of Short Stents in Coronary Artery Long Lesions by Myocardial Fractional Flow Reserve Guided

目的:观察心肌血流储备分数(FFR)指导下短支架在冠脉长病变中的临床应用。方法:选取本院在2014年1月-2015年1月期间收治的60例冠脉长病变患者作为研究对象,根据随机数表法将所有患者分为对照组和观察组,每组30例。对照组患者给予以长药物支架(DES)植入,观察组患者在FFR测定指导下,选择最严重部位后予以DES植入,术后严格规范药物治疗,分别随访30 d、3个月、6个月及1年,观察记录患者住院时间、支架使用数量及随访中主要心脏不良事件。结果:对照组和观察组患者植入支架成功率均为100%(30/30),比较差异无统计学意义(P>0.05)。观察组患者植入支架数量和住院时间均显著低于对照组,比较差异有统计学意义(P<0.05)。术后随访1年,观察组患者支架心绞痛、再狭窄率和再次再建术的发生率显著低于对照组,比较差异均有统计学意义(P<0.05)。结论:FFR指导下短支架应用于指冠脉长病变,可显著降低患者住院时间和支架使用数量,且显著降低心绞痛、支架再狭窄及再次血运建术等不良事件的发生率。

Objective： To evaluate the clinical application of short stents in coronary artery lesions by myocardial fractional flow reserve （FFR） guided.Method： From＇January 2014 to January 2015, 60 patients with coronary artery long lesions were selected in our hospital, they were randomly divided into control group and observation group, 30 cases in each group.The control group was treated with long drug-eluting stents implantation, observation group was treated with short stents under the guidance of myocardial fractional now reserve.Strictly regulate drug therapy after surgery, hospitalization days, number of stents and adverse events of two groups were compared and followed 30 day, 3 months, 6 months and 1 year after operation. Result： The success rates of two groups were both 100%, the difference was no statistically significant （ P〈0.05 ） . The implanted stent number and length of hospital stay in observation group were significantly lower than control group, the differences were statistically significant （ P〈0.05 ） .Postoperative follow-up of 1 year, the incidence rate of angina pectoris, restenosis and build again of observation group were significantly lower than control group, the differences were statistically significant （ P〈0.05 ） .Conclusion： Score of myocardial fractional flow reserve under the guidance of short bracket used in long coronary lesions, can significantly reduce the in-hospital time, number of stent, the angina peetoris, stent restenosis and blood supply again building the incidence of adverse events.