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目的比较血管内超声检查(IVUS)和血流储备分数测定(FFR)在指导冠状动脉临界病变治疗中的临床效果。方法将94例行冠状动脉造影提示冠状动脉临界病变的患者分为IVUS组和FFR组,分别接受IVUS或FFR检查,并以此为依据指导冠状动脉介入治疗。在IVUS组中,如MLA<4mm2或冠状动脉狭窄虽不足,但IVUS显示为不稳定斑块,则行冠状动脉介入治疗(PCI);在FFR组中,以FFR<0.75作为行冠状动脉支架置入术的指征。术后随访6个月,比较两组患者心血管不良事件的发生情况。结果 (1)两组患者病史等一般信息及冠状动脉造影情况差异无统计学意义(P>0.05)。(2)IVUS组行介入治疗的比例高于FFR组(P<0.01)。(3)两组间不良事件的发生情况差异无统计学意义(P>0.05)。结论 IVUS和FFR检查均可用于指导冠状动脉临界病变的介入治疗,受准确性的限制IVUS不能取代FFR检查的地位。
Objective To compare the clinical effects of intravascular ultrasound (IVUS) and flow reserve fraction (FFR) in guiding the treatment of critical coronary artery disease. Methods Ninety-four patients undergoing coronary angiography to show the critical lesions of coronary artery were divided into IVUS group and FFR group. They were given IVUS or FFR respectively, which guided the intervention of coronary artery. In the IVUS group, coronary intervention (PCI) was performed with IVUS as an unstable plaque, such as MLA <4 mm 2 or coronary artery stenosis, and in the FFR group FFR <0.75 was used as the coronary stent Indications for surgery. After 6 months of follow-up, the occurrence of cardiovascular adverse events in both groups was compared. Results (1) There was no significant difference between the two groups in general information such as medical history and coronary angiography (P> 0.05). (2) The proportion of interventional intervention in IVUS group was higher than FFR group (P <0.01). (3) There was no significant difference in the occurrence of adverse events between the two groups (P> 0.05). Conclusion Both IVUS and FFR can be used to guide the interventional treatment of critical coronary artery disease. Due to the limitation of accuracy, IVUS can not replace the status of FFR.