血流储备分数指导中老年冠心病介入治疗的临床分析

Cli nical Analysis of the Effect of Interventional Therapy Guided by Fractional Flow Reserve in the Treatment of Middle-aged and Elderly Patients with Coronary Heart Disease

目的分析血流储备分数指导中老年冠心病介入治疗的临床效果。方法随机抽取2011年4月—2014年12月该院收治的98例冠心病患者的临床资料作为研究对象,将其分为FFR指导冠脉介入治疗组与常规冠脉介入治疗组各49例,对照组使用冠脉介入治疗,治疗组使用血流储备分数测定,对两组患者的临床效果、手术时间、造影剂使用量、不良情况、植入支架累计数等进行比较。结果常规冠脉介入治疗组的手术时间(69±23)h、造影剂使用量(256±114)m L、植入支架累计数(2.1±0.9)min、心绞痛12.62%,FFR指导冠脉介入治疗组手术时间(65±27)h、造影剂使用量(187±99)m L、植入支架累计数(1.6±0.8)min,心绞痛10.25%,通过两组患者的比较,FFR指导冠脉介入治疗组的造影剂使用量要比常规冠脉介入治疗组低(P<0.05)。其中两组患者的手术时间、心脏不良反应、植入支架累计数等的比较差异无统计学意义(P>0.05)。结论根据临床结果来看,血流储备分数指导中老年冠心病介入治疗,可以降低造影剂在临床中的使用量、植入支架累计量等,对植入支架的贴壁有显著的效果,在临床中值得广泛使用。

Objective To analyze the clinical effect of interventional therapy guided by fractional flow reserve in the treatment of middle-aged and elderly patients with coronary heart disease(CHD). Methods The clinical data of 98 cases with CHD admitted in our hospital from April 2011 to December 2014 were selected as the subjects. The patients were divided into the coronary interventional therapy guided by FFR group and the conventional coronary interventional therapy group with 49 cases in each group. The control group were treated by coronary interventional therapy, and the treatment group were treated by coronary interventional therapy guided by FFR. And the clinical effect, duration of procedure, dose of contrast medium,incidence of adverse reactions, and accumulative stent placement of the two groups were compared. Results There was no statistically significant difference in the duration of procedure between the conventional coronary interventional therapy group and the coronary interventional therapy guided by FFR group [(69 ±23)h vs(65±27)h](P>0.05). The dose of contrast medium used in the coronary interventional therapy guided by FFR group was much less than that used in the conventional coronary interventional therapy group [(187±99) m L vs(256±114) m L](P<0.05). 12.62% of the patients in the conventional coronary interventional therapy group had angina pectoris, and 10.25% of those in the coronary interventional therapy guided by FFR group had angina pectoris, the difference in the incidence of cardiac adverse reactions between the two groups was not statistically significant(P>0.05). The accumulative stent placement was(2.1±0.9)min in the conventional coronary interventional therapy group, and(1.6±0.8)min in the coronary interventional therapy guided by FFR group, the difference between the two groups was not statistically significant(P>0.05). Conclusion According to the clinical results, interventional therapy guided by FFR for middle-aged and elderly patients with CHD can reduce the dose of contrast medium used in surgery, accumulative stent placement with significant effect on the stent pressing to the wall of vessels, therefore, it is worthy of wide clinical application.