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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
丁钰轩,王永进,高宏波,杜亚坤,卫娇娜.血流储备分数指导下完全血运重建对非ST段抬高型急性冠脉综合征多支血管病变患者预后的影响[J].中华老年多器官疾病杂志,2018,17(2):111~115
血流储备分数指导下完全血运重建对非ST段抬高型急性冠脉综合征多支血管病变患者预后的影响
Prognostic impact of functionally complete revascularization guided by fractional flow reserve in patients with non-ST segment elevation acute myocardial infarction
投稿时间:2017-07-09  修订日期:2017-09-27
DOI:10.11915/j.issn.1671-5403.2018.02.024
中文关键词:  血流储备分数;非ST段抬高型急性冠脉综合征;功能性血运重建;多支血管病变;主要不良心血管事件
英文关键词:fractional flow reserve; non-ST segment elevation acute coronary syndrome; functionally complete revascularization; multi-vessel disease; major adverse cardiovascular events
基金项目:
作者单位E-mail
丁钰轩 陕西省汉中市人民医院心内科,汉中 723000 ding829852@163.com 
王永进 陕西省汉中市人民医院心内科,汉中 723000  
高宏波 陕西省汉中市人民医院心内科,汉中 723000  
杜亚坤 陕西省汉中市人民医院心内科,汉中 723000  
卫娇娜 陕西省汉中市人民医院心内科,汉中 723000  
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中文摘要:
      目的 探讨血流储备分数(FFR)指导下完全血运重建对非ST段抬高型急性冠脉综合征(NSTE-ACS)多支血管病变患者预后的影响。方法 100例NSTE-ACS多支血管病变患者随机分为FFR指导下功能性完全血运重建组(FFR组)和单纯冠状动脉造影(CAG)指导下完全血运重建组(CAG组),比较两组人均支架植入数量、住院费用等经皮冠状动脉介入(PCI)资料;患者术后随访12个月,比较两组心绞痛发作次数、左室射血分数(LVEF)和主要不良心血管事件(MACEs)发生率。采用SPSS 19.0统计学软件分析处理数据,组间比较采用t检验或卡方检验。结果 FFR组人均支架植入数量[(2.0±1.5) vs (3.5±1.8)枚,P<0.01]和住院费用[(43905±26242) vs (65884±20489)元,P=0.04]较CAG组显著降低;术后1个月心绞痛发作次数[(2.3±0.7) vs (4.1±0.5)次]和LVEF[(62.7±6.8)% vs (54.7±7.9)%]改善情况优于CAG组;术后12个月FFR组再次血运重建[4.1%(2/49) vs 17.8%(8/45),P=0.03]和MACEs发生率[8.2%(4/49) vs 24.4%(11/45),P=0.03]较CAG组显著降低。结论 FFR指导下功能性完全血运重建减少支架植入数量和住院费用,有效改善术后1个月心绞痛症状和心功能,降低术后12个月MACEs发生率,NSTE-ACS多支血管病变患者短期获益明显。
英文摘要:
      Objective To investigate the effect of functionally complete revascularization guided by fractional flow reserve (FFR)on the prognosis in the patients with non-ST segment elevation acute coronary syndrome(NSTE-ACS) and multi-vessel disease (MVD). Methods A total of 100 NSTE-ACS and MVD patients admitted in the Cardiological Department of the Hanzhong People’s Hospital from January to July 2016 were enrolled in this study. They were randomly divided into FFR group (undergoing functionally complete revascularization guided by FFR) and CAG group (receiving coronary angiography guided PCI treatment). The number of implanted stents, hospitalization expenses, and data of PCI were compared between the 2 groups.In the follow-up of 12 months,angina attacks, left ventricular ejection fraction(LVEF) and occurrence of major adverse cardiovascular events (MACEs) were also compared. SPSS statistics 19.0 was used for data processing. Student’s t test or Chi-square test were used to compare the differences between groups. Results Compared with the CAG group, the FFR group had less implanted stents [(2.0±1.5) vs (3.5±1.8), P<0.01] and lower hospitalization expenses [(43905±26242) vs (65884±20489)CNY, P=0.04], and better improved angina symptoms [(2.3±0.7) vs (4.1±0.5)times] and LVEF [(62.7±6.8)% vs (54.7±7.9)%]. The incidences of revascularization [4.1%(2/49) vs 17.7%(8/45), P=0.03] and MACEs [8.2%(4/49) vs 24.4%(11/45), P=0.03] were also significantly lower in the FFR group than in the CAG group. Conclusion Functionally complete revascularization guided by FFR significantly reduces the number of stents and hospitalization expenses, effectively improves the symptoms of angina attacks and heart function, and decreases the incidence of MACEs in 12 months after surgery. The approach shows obvious short-term benefit to the NSTE-ACS and MVD patients.
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