摘要
目的探究稳定型心绞痛患者冠状动脉功能性缺血的影响因素,并分析其对于冠状动脉功能性缺血的诊断价值。方法连续入选2017年8月至2019年6月,在新疆医科大学第一附属医院行冠状动脉造影提示冠状动脉临界病变,同时接受冠状动脉血流储备分数(FFR)检测的稳定型心绞痛患者354例。根据FFR结果分为两组:A组[FFR≥0.8(212例)]、B组[FFR<0.8(142例)]。结果两组患者血细胞比容(HCT)、高密度脂蛋白胆固醇(HDL-C)、血管病变数、吸烟等指标比较,差异均有统计学意义(均P<0.05)。相关性分析表明,HCT、HDL-C、血管病变数、吸烟与FFR值存在显著的相关性。logistic单因素及多因素回归方程分析表明,HCT(OR 1.067,95%CI 1.008~1.129,P=0.025)、血管病变数(OR 1.610,95%CI 1.143~2.266,P=0.006)是影响冠状动脉功能性缺血的独立危险因素,HDL-C(OR 0.304,95%CI 0.130~0.712,P=0.006)是冠状动脉功能性缺血的独立保护因素。利用受试者工作特征曲线评估,联合多个影响因素对冠状动脉功能性缺血具有一定的预测价值(AUC 0.656,95%CI 0.597~0.714,P<0.001)。结论对于稳定型心绞痛临界病变患者,HCT、HDL-C、血管病变数对冠状动脉功能性缺血有独立预测作用,对指导冠状动脉血运重建有一定价值。
Objective To explore the factors affecting functional ischemia of coronary artety in patients with stable angina pectoris and analyze the diagnostic value of functional coronary ischemia.Methods From August 2017 to June 2019,354 patients with stable angina pectoris who underwent coronary angiography in the First Affilated Hospital of Xinjiang Medical University to indicate intermediate lesions and also received coronary artery fractional flow reserve(FFR) testing were consecutively enrolled.If the FFR was less than 0.8,coronary functional ischemia was considered.According to the FFR,the patients were divided into two groups:group A with FFR≥0.8(n=212) and group B with FFR<0.8(n=142).Results The hematocrit(HCT),highdensity lipoprotein cholesterol(HDL-C),the number of vascular lesions,and the number of smoking were all statistically significant(P<0.05) between the two groups.Correlation analysis showed that hematocrit,HDL-C,the number of vascular lesions,the number of cigarettes and the FFR value were significantly correlated.Through univariate and multivariate logistics regression analysis,hematocrit(OR 1.067,95%CI 1.008-1.129,P=0.025),the number of vascular lesions(OR 1.610,95%CI 1.143-2.266,P=0.06) were independent risk factors with functional ischemia.High-density lipoprotein cholesterol(OR 0.304,95%CI 0.130-0.712,P=0.006)was an independent protective factor for functional ischemia.The receiver operating characteristic curve(ROC curve) was used to evaluate the combination of multiple influencing factors with a certain predictive value for functional ischemia(A UC 0.656,95%CI 0.597-0.714,P<0.001).Conclusions For patients with intermediate lesions of stable angina pectoris,HCT,HDL-C,and the number of vascular lesions have independent predictive effects on functional coronary ischemia,and have certain value in guiding coronary revascularization.
作者
张雪鹤
赵倩
宋宁
尼亚孜艾力·阿迪力
古兰旦木·艾合麦提
胡恺轩
李晓梅
ZHANG Xue-he;ZHAO Qian;SONG Ning;NIYAZIAILI·Adili;GULANDANMU·AiHemaiti;HU Kai-xuan;LI Xiao-mei(Department of Cardiology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《中国介入心脏病学杂志》
2020年第12期680-684,共5页
Chinese Journal of Interventional Cardiology
基金
新疆维吾尔自治区创新条件(人才、基地)建设专项(科技创新基地建设计划--重点实验室建设)(2018D04029)
国家自然科学基金(81660058)
新疆医科大学研究生创新创业启动基金(CXCY2018039)。
关键词
稳定型心绞痛
血流储备分数
临界病变
Stable angina pectoris
Fractional fl ow reserve
Intermediate lesions
