CT冠状动脉造影和CT血流储备分数在可疑冠心病患者中的应用

Application of CT coronary angiography and CT fractional flow reserve in patients with suspected coronary heart disease

目的:探讨CT冠状动脉造影(CTCA)和CT血流储备分数(CT-FFR)在可疑冠心病患者中的应用效果。方法:选择2018年1月—2020年3月在我院接受CTCA心脏血流分析的137例患者进行研究,计算患者的CT-FFR值,评估CT-FFR检查与CTCA和有创冠脉造影(CAG)之间的差异。结果:CT-FFR与CAG检查血管狭窄不一致率为15.65%(41/262);CTCA与CAG检查血管狭窄不一致率为18.32%(48/262)。CTCA和CT-FFR检查比较存在统计学差异,CT-FFR检查经皮冠状动脉介入治疗(PCI)率高于CTCA(P<0.05)。CT-FFR分析阳性的血管保留CAG和PCI,CAG的检查率可从100%(262/262)降低至45.02%(118/262),降低54.98%。PCI率从37.40%(98/262)降低至32.82%(86/262),降低4.58%。结论:CT-FFR有助于对可疑冠心病患者CAG适应证的进一步筛选。

Objective:To investigate the application effect of CT coronary angiography(CTCA)and CT fractional flow reserve(CT-FFR)in patients with suspected coronary heart disease.Methods:From January 2018 to March 2020,137 patients who received CTCA cardiac blood flow analysis in our hospital were selected for the study.The CT-FFR value was calculated to evaluate the difference between CT-FFR and CTCA and invasive coronary angiography(CAG).Results:The discordance rate of stenosis between CT-FFR and CAG was 15.65%(41/262).The discordance rate of stenosis between CTCA and CAG was18.32%(48/262).CTCA and CT-FFR treatment tendency was statistically different,and CT-FFR tended to have higher percutaneous coronary intervention(PCI)rate than CTCA(P<0.05).If CT-FFR analysis was positive,CAG and PCI were retained,and the incidence of CAG was reduced from 100%(262/262)to 45.02%(118/262),with a reduction of 54.98%,while the rate of PCI decreased from 37.40%(98/262)to 32.82%(86/262),with a decrease of 4.58%.Conclusion:CT-FFR is helpful for further screening of CAG indications in patients with suspected coronary heart disease.