%0 Journal Article
%T PCI后FFR值对冠状动脉中度狭窄患者主要心脏不良事件发生的预测价值
%A 王晓腾　王海曙　宋安　延荣强　王正忠　于忠祥　李贞福
%J -
%D 2020
%R 10.13362/j.jpmed.202002012
%X 摘要 目的　探讨经皮冠状动脉支架植入术（PCI）后血流储备分数（FFR）对冠状动脉中度狭窄冠心病患者主要心脏不良事件（MACE）发生的预测价值。 方法　回顾性分析2017年1月—2019年2月就诊于我院并行冠脉造影（CAG）检查示冠状动脉至少一支为中度狭窄病变的冠心病患者210例，其中联合FFR指导实行PCI治疗的患者共有121例，收集并记录患者入院时的基本资料及PCI相关资料，随访至少12个月，根据患者在随访期间有无MACE发生（定义为典型心绞痛、再发心肌梗死、死亡），将患者分为MACE组和无MACE组。采用单因素分析方法比较两组患者的基线资料、PCI相关资料，多因素二元Logistic回归分析方法分析PCI后患者发生MACE的相关因素，ROC曲线分析靶血管PCI后FFR对患者MACE发生的预测价值。 结果　本研究共纳入121例患者，其中9例患者未完成术后FFR值的测定，8例患者失访，最终有104例患者纳入研究，发生MACE的患者14例（MACE组），包括典型心绞痛症状10例，心肌梗死4例，均行CAG检查明确是否为靶血管病变，无MACE组患者90例。单因素分析显示两组患者PCI后FFR、PCI前FFR及入院次日的红细胞分布宽度水平比较差异有显著性（t=－2.879～4.104，P＜0.01）。二元Logistic回归分析方法分析结果显示，靶血管PCI后FFR值升高的患者发生MACE事件的概率降低（OR=0.700，95%CI=0.566～0.866，P＜0.01）；ROC曲线显示，分析MACE发生最适宜的截断值为靶血管PCI后FFR=0.905，其特异度为86.0%，灵敏度为64.4%，靶血管PCI后FFR值升高的患者发生MACE事件的概率降低（AUC=0.805，95%CI=0.697～0.912，P＜0.01）。 结论　FFR指导下行PCI治疗的冠状动脉中度狭窄患者，靶血管PCI后FFR值与MACE事件的发生呈负相关，并且对MACE的发生具有预测价值。<br>Abstract：Objective　To investigate the value of fractional flow reserve (FFR) after percutaneous coronary intervention (PCI) in predicting major adverse cardiac events (MACE) in patients with moderate coronary artery stenosis. Methods　A retrospective analysis was performed for the clinical data of 210 patients with coronary heart disease who underwent coronary angiography (CAG) in our hospital from January 2017 to February 2019 and were found to have moderate stenosis of at least one branch of the coronary artery, among whom 121 patients underwent PCI under the guidance of FFR. Basic information on admission and PCI data were collected, and the patients were followed up for at least 12 months. According to the presence or absence of MACE (defined as typical angina pectoris, recurrent myocardial infarction, and death) during follow-up, the patients were divided into MACE group and non-MACE group. A univariate analysis was used to compare the baseline data and PCI data between the two groups, a multivariate binary logistic regression analysis was used to analyze the factors for MACE in patients after PCI, and the receiver operating characteristic (ROC) curve was used to analyze the value of post-PCI FFR of target vessel in predicting MACE. Results　A total of 121 patients were enrolled in this study, among whom 9 patients did not complete post-PCI FFR measurement and 8 patients were lost to follow-up, and finally 104 patients entered the study, among whom 14 patients experienced MACE (MACE group) (10 patients with typical angina pectoris and 4 with myocardial infarction) and underwent CAG to determine whether it was a target vascular disease, and 90 patients did not experience MACE. The univariate analysis showed that there
%K 冠状动脉狭窄
%K 冠心病
%K 经皮冠状动脉介入治疗
%K 血流储备分数
%K 心肌
%K 心脏损伤
%K 预测<br>Coronary stenosis
%K Coronary disease
%K Percutaneous coronary intervention
%K Fractional flow reserve
%K myocardial
%K Heart injuries
%K Forecasting
%U http://jpmed.qdu.edu.cn/CN/10.13362/j.jpmed.202002012