血管内超声和血流储备分数测定在冠状动脉临界病变治疗中的作用

Application of intravascular ultrasound and fractional flow reserve on treatment of coronary intermediate lesion

目的比较血管内超声检查(IVUS)和血流储备分数测定(FFR)在指导冠状动脉临界病变治疗中的临床效果。方法将94例行冠状动脉造影提示冠状动脉临界病变的患者分为IVUS组和FFR组,分别接受IVUS或FFR检查,并以此为依据指导冠状动脉介入治疗。在IVUS组中,如MLA<4mm2或冠状动脉狭窄虽不足,但IVUS显示为不稳定斑块,则行冠状动脉介入治疗(PCI);在FFR组中,以FFR<0.75作为行冠状动脉支架置入术的指征。术后随访6个月,比较两组患者心血管不良事件的发生情况。结果 (1)两组患者病史等一般信息及冠状动脉造影情况差异无统计学意义(P>0.05)。(2)IVUS组行介入治疗的比例高于FFR组(P<0.01)。(3)两组间不良事件的发生情况差异无统计学意义(P>0.05)。结论 IVUS和FFR检查均可用于指导冠状动脉临界病变的介入治疗,受准确性的限制IVUS不能取代FFR检查的地位。

Objective To compare the clinical effects of intravascular ultrasound（IVUS）and blood flow reserve fraction（FFR）in guiding the treatment of critical disease of coronary artery.Methods Forty-nine patients with coronary artery disease who underwent coronary angiography were divided into IVUS group（n=43）and FFR group（n=51）.In IVUS group,such as MLA 4mm2 or coronary artery stenosis was insufficient,but IVUS showed unstable plaque,and we went the PCI treatment;in the FFR group,FFR0.75 was regarded as coronary stenting sign.The patients were followed up for 6months.The incidence of cardiovascular adverse events was compared between the two groups.Results（1）There was no significant difference in general information and coronary angiography between the two groups（P〉0.05）.（2）The proportion of interventional therapy in IVUS group was higher than that in FFR group（P〈0.01）.（3）The incidence of adverse events between the two groups was not statistically significant（P〉0.05）.Conclusion IVUS and FFR examination can be used to guide the interventional treatment of critical disease of coronary artery.However,the accuracy of IVUS can not replace the status of blood flow reserve.