定量血流分数在冠状动脉多支临界病变治疗中的价值

The value of quantitative flow ratio in the treatment of multi-vessel coronary borderline lesions

目的分析定量血流分数(QFR)在多支冠状动脉临界病变经皮冠状动脉介入治疗(PCI)中的价值。方法选取济宁医学院附属医院2020年10月至2021年4月患有多支冠状动脉临界病变的患者270例,随机分为3组:QFR指导组90例,由QFR分析优化PCI;血管内超声(IVUS)指导组90例,由IVUS分析优化PCI;冠状动脉造影(CAG)指导组90例,均不行QFR分析和IVUS分析,由CAG指导PCI。比较3组患者支架植入数量、手术费用及术后12月复发心绞痛、主要心血管事件(MACE)发生率。结果QFR指导组支架植入数量91枚,平均花费(22255.66±10908.68)元,复发心绞痛1例(1.1%),3项指标均优于CAG指导组和IVUS指导组(P<0.05)。结论QFR应用于多支冠状动脉临界病变的PCI优化,可显著降低支架植入数量,降低医疗成本,在血运重建率明显降低的同时减少术后心绞痛的发生。

Objective To explore the value of quantitative flow ratio(QFR)in percutaneous coronary intervention(PCI)for multi-vessel coronary borderline lesions.Methods 270 patients with multi-vessel coronary borderline lesions from October 2020 to April 2021 in the Affiliated Hospital of Jining Medical University were selected,and they were randomly divided into QFR guidance group,IVUS guidance group and CAG guidance group,90 cases in each group.The QFR guide group was guided by QFR analysis to optimize PCI,the IVUS guide group was guided by IVUS analysis to optimize PCI,and the CAG guide group was guided by CAG guide to optimize PCI.The number of stent implantation,operation cost,12-month postoperative recurrence of angina pectoris,and the incidence of major cardiovascular events(MACE)were compared among the three groups were compared.Results The number of stents implanted,the operation cost and the recurrence rate of angina pectoris 12 months after the operation in the QFR guidance group were lower than those in the CAG guidance group and the IVUS guidance group(P<0.05).Conclusion The application of QFR in the optimization of PCI for multi-vessel coronary borderline lesions can significantly reduce the number of stents,medical costs,and the incidence of postoperative angina pectoris while reducing the revascularization rate.