冠状动脉功能学评估在经皮冠状动脉介入治疗术后的应用进展

Application progress of coronary artery functional evaluation after percutaneous coronary intervention

如今经皮冠状动脉介入治疗(PCI)的目的已从单纯治疗狭窄病变转变为治疗缺血心肌并改善患者远期预后。由于血流储备分数(FFR)能够反映冠状动脉的功能学特征,现已成为评估冠状动脉病变导致心肌缺血严重程度的金标准。FFR在指导PCI临床决策中的作用已被大量研究证实,多用于在PCI术前帮助术者决定是否行支架置入。近年来,越来越多的专家认识到支架置入术后冠状动脉功能学评估的重要性。虽然有研究表明,PCI术后即刻功能学评估与患者预后相关,但对如何进行术后功能学评估及其意义尚未得到重视。本文对冠状动脉功能学评估在PCI术后的应用进展作一综述。

In contemporary coronary intervention,the aim of percutaneous coronary intervention(PCI)has transformed from treating stenosis to treating ischemia,so as to improve the long-term prognosis of the patients.Fractional flow reserve(FFR)has now become the gold standard for diagnosing the severity of coronary artery lesions,because of its ability to reflect the functional characteristics of coronary arteries.The role of FFR in guiding clinical decisions for PCI has been confirmed by numerous studies.Nowadays,FFR is mainly used to aid the decision-making of revascularization on the pre-interventional period,yet there is a lack of consensus on how to perform FFR in the post-PCI period,and the value of its application after the intervention has not been well established.Some studies have shown that immediate functional assessment post-PCI period is associated with the optimization of stent implantation and the long-term prognosis of patients.This paper reviews the application progress of coronary functional assessment in the post-PCI period.