目的:研究血管内超声(IVUS)与压力血流储备(FFR)在冠状动脉临界病变中的长期随访研究。方法:2014年5月至2015年5月,经过冠状动脉造影(QCA)分析证实病变狭窄处于临界病变的住院患者78例,排除20例,共计58例患者入选。对QCA测定直径狭窄30%~50%临界病变的患者进行随机分组:血管内超声组29例,压力血流储备组29例。通过压力导丝测定相关数值<0.75,IVUS最小管腔面积≤4.0mm2或者面积狭窄率≥70%的患者,积极给予介入干预治疗。术后规律服用药物,观察两组围手术期间以及1年随访的主要心血管事件。结果:IVUS组依据临界病变的指标进行判定,有8例超出临界病变的标准,其中发现前降支病变5例,混合斑块1例,6例明显钙化灶;依据FFR数值<0.75患者共计7例,给予介入干预治疗。术后给予规律冠心病二级预防。IVUS组3例失访,随访率90%。1例再发作心绞痛入院介入治疗;FFR组4例失访,随访率86%。3例再发作心绞痛入院介入治疗。结论:对于临界病变的患者,采用IVUS的方法能够检测出更多易损斑块等情况,联合QCA结合FFR能够提供临界病变患者危险分层依据,术中、术后FFR值越高,临床不良事件发生率就越低,患者长期预后越好。 Objective: To study the long-term follow-up of intravascular ultrasound (IVUS) and pressure flow reserve (FFR) in critical coronary artery disease. METHODS: From May 2014 to May 2015, 78 patients with critical lesions were confirmed by coronary angiography (QCA) analysis. Twenty patients were excluded, and a total of 58 patients were enrolled. Patients undergoing QCA for the determination of 30% to 50% of stenosis were randomly assigned to intravascular ultrasound group (n = 29) and pressure and blood flow reserve group (n = 29). Interventional intervention was actively given to patients with a correlation value of <0.75, a minimal lumen area of ​​IVUS ≤ 4.0 mm2 or an area of ​​stenosis ≥ 70% by pressure guidewire. After regular medication, the two major cardiovascular events were observed during the perioperative period and at 1-year follow-up. Results: According to the index of critical disease in IVUS group, there were 8 out of the critical disease criteria, including 5 cases of anterior descending coronary artery disease, 1 case of mixed plaque and 6 cases of obvious calcification. According to FFR <0.75, Cases, given intervention interventions. Postoperative regular coronary heart disease secondary prevention. Three patients in IVUS group were lost and the follow-up rate was 90%. One case of recurrent angina pectoris admitted to hospital; 4 cases of FFR group were lost, the follow-up rate was 86%. 3 cases of recurrent angina pectoris admission interventional treatment. Conclusion: IVUS can detect more vulnerable plaques in patients with critical lesions. Combining QCA with FFR can provide a basis for risk stratification in patients with critical lesions. The higher the postoperative FFR value, the worse the clinical outcome The lower the incidence of events, the better the patient’s long-term prognosis.