摘要
目的:分析定量血流分数(quantitative flow ratio,QFR)对冠状动脉病变药物球囊治疗的指导作用,评价其治疗效果和可行性。方法:纳入2021年6月至2022年6月陆军第八十二集团军医院心肾内科心脏病区冠心病择期手术的96例患者,对冠状动脉造影提示管腔狭窄≥50%的病变血管进行QFR分析,指导临床治疗决策。治疗后再次进行QFR分析,评价QFR值改善以及术后6个月临床结局。结果:96例患者125支冠状动脉血管进行QFR分析,66例患者的90支血管QFR阳性。其中82支成功使用药物球囊扩张冠状动脉病变但未置入支架,包括:支架内再狭窄21支(25.6%)、主支/较大边支44支(53.7%),主支置入支架后边支血管17支(20.7%)。药物球囊治疗后心肌缺血状况得到明显改善,QFR值由治疗前的0.66增加到治疗后的0.94(P<0.001)。药物球囊治疗6个月终点事件发生率为4.5%(3/66),均缺血驱动的靶血管重建。靶血管再狭窄率为3.7%(3/82)。结论:QFR技术可指导冠状动脉病变治疗决策的选择,基于QFR技术的药物球囊应用可显著改善心肌缺血状况,术后6个月靶血管再狭窄发生率为3.7%,研究结果尚待前瞻性研究验证。
Objective:This study aimed to evaluate the guiding role of quantitative flow ratio(QFR)in the treatment of coronary artery lesions using drug-coated balloons(DCB),and to assess the feasibility and effectiveness of this therapeutic approach.Methods:A total of 96 patients with coronary artery disease(CAD)who underwent elective surgery at the Cardiology Department of the 82nd Army Group Hospital from June 2021 to June 2022 were enrolled.QFR analysis was performed on coronary arteries with angiographically confirmed stenosis of≥50%to guide clinical treatment decisions.Post-treatment QFR values were analyzed to assess improvements,and clinical outcomes were monitored for six months after the procedure.Results:QFR analysis was performed on 125 coronary vessels from 96 patients,with 90 vessels from 66 patients showing positive QFR values.Successful DCB treatment was achieved in 82 vessels without stent implantation,including 21 in-stent restenosis lesions(25.6%),44 main or large branch lesions(53.7%),and 17 side branch lesions after main branch stent implantation(20.7%).Myocardial ischemia significantly improved after DCB treatment,with the QFR increasing from 0.66 pre-treatment to 0.94 post-treatment(P<0.001).The incidence of major adverse cardiac events at 6-month follow-up was 4.5%(3/66),all of which were ischemia-driven target vessel revascularizations.The target vessel restenosis rate was 3.7%(3/82).Conclusions:QFR is a valuable tool in guiding treatment decisions for coronary artery lesions.DCB therapy based on QFR guidance significantly improves myocardial ischemia,with a 6-month target vessel restenosis rate of 3.7%.These findings warrant further validation through prospective studies.
作者
王祥贺
曹雪滨
罗军
张婷
刘虹宏
崔玉娟
刘兆川
WANG Xianghe;CAO Xuebin;LUO Jun;ZHANG Ting;LIU Honghong;CUI Yujuan;LIU Zhaochuan(Cardio-renal Department Cardiology Section of The Hospital of 82nd Group Army PLA,Baoding 071000,China)
出处
《心肺血管病杂志》
2025年第2期136-141,共6页
Journal of Cardiovascular and Pulmonary Diseases
基金
保定市科技计划项目(2241ZF391)。
