血流储备分数评估老年冠心病患者介入治疗后分叉病变血管功能的研究

The clinical application of fractional flow reserve in evaluating the function of bifurcated vessels in elderly patients with coronary heart disease after percutaneous coronary intervention

目的:探讨血流储备分数对老年冠心病患者冠状动脉介入(PCI)治疗后分叉病变血管功能的评估.方法:选取冠心病分叉病变入院并行PCI术的老年患者96例,分为观察组48例,对照组48例,观察组依据病变血管冠状动脉造影结合FFR值测定,选择合适治疗策略,对照组依据冠状动脉造影结果选择合适治疗策略.比较两组患者分叉病变血管狭窄率、支架置入情况、PCI术后分叉病变血管残余狭窄率、分叉病变血管血流TIMI3级发生率、3个月后主要不良心血管事件发生率及西雅图心绞痛评分(SAQ).结果:观察组轻中度狭窄支架置入率及TIMI血流3级比例显著高于对照组(P<0.05),且术后分叉病变血管残余狭窄率显著低于对照组(P<0.05).主要不良心血管事件发生率,显著低于对照组(P<0.05),心绞痛稳定状态,心绞痛发作情况及治疗满意程度均显著高于对照组(P<0.05).结论:FFR测定对于评估老年冠心病患者PCI术后分叉病变血管功能,指导临床治疗策略,降低过度干预及分叉血管再闭塞的,减少不良心血管事件发生率,改善患者生活质量有一定的临床价值.

Objective:Evaluate the effect of fractional flow reserve(FFR)on the function of bifurcated vessels in elderly patients with coronary heart disease after percutaneous coronary intervention(PCI)to provide a theoretical basis for the selection of appropriate treatment strategies for bifurcated vessels in elderly patients with coronary heart disease after PCI.Methods:Ninety-six elderly patients with coronary heart disease bifurcation lesion admitted to hospital and underwent PCI intervention were selected and divided into research group(48 cases)and control group(48 cases).For research group,the appropriate treatment strategy is selected according to the coronary arteriography and FFR of lesion blood vessel.The control group selected appropriate treatment strategies according to the result of coronary angiography.Compare the vascular stenosis rate of bifurcation lesion,stent placement rates,residual vascular stenosis rate of bifurcation lesions after PCI postoperative,the rate which the blood flow got TIMI 3.the incidence of major adverse cardiac events after 3 months and Seattle angina score(SAQ).Results:The stents implantation rate of mild to moderate stenosis and blood flow rate-TIMI grade 3 in the research group was significantly more than that in the control group(P<0.05),and their residual stenosis rate after PCI was significantly less than that in the control group(P<0.05),the incidence of major adverse cardiac events,and the incidence of angina pectoris significantly less than the control group(P<0.05),and the angina stability(AS),angina frequency and Treatment satisfaction of research were significantly more than that of control group(P<0.05).Conclusions:FFR measurement has certain clinical value in evaluating the vascular function of bifurcated lesions in elderly patients with coronary heart disease after PCI,guiding clinical treatment strategies,reducing excessive intervention and bifurcated vessel reocclusion,reducing the incidence of major adverse cardiovascular events,and improving the quality of life of patients.