目的：分析血流储备分数(FFR）与冠状动脉造影(CAG）指导的治疗对非 ST 段抬高急性冠状动脉综合征(NSTEACS）患者冠状动脉中度狭窄病变临床预后的影响。方法回顾性分析2014年7月1日至2015年7月30日在北京安贞医院行 CAG 显示为冠状动脉中度狭窄病变且行FFR 检查的 NSTEACS 患者,共142例(FFR 组）,与同时期仅行 CAG 的 NSTEACS 冠状动脉中度狭窄患者以1：2进行匹配,后者共284例(CAG 组）。分析随访期间主要不良心血管事件(MACE,包括心原性死亡、靶血管血运重建、非致死性心肌梗死）发生情况。结果 FFR 组行经皮冠状动脉介入治疗(PCI）的患者比例(36.6%比46.8%,P =0.037）、住院费用[(3.24±1.62）万元比(4.16±3.23）万元,P =0.033]、非致死性心肌梗死发生率(2.2%比4.5%,P =0.040）及靶血管血运重建率(5.9%比11.7%,P =0.046）均低于 CAG 组,差异均有统计学意义；而两组患者总 MACE 发生率及心原性死亡率比较,差异均无统计学意义(均 P >0.05）。结论在 NSTEACS 患者中,FFR 结合 CAG 指导的治疗可减少支架置入比例和住院费用,并可改善该类患者的临床预后。%Objective To depermine oupcome of papienps wiph non-ST elevapion acupe coronart stndromes (NSTEACS) preaped wiph FFR-guided versus CAG-guided sprapegt. Methods From Jult 1. 2014 po Jult 30. 2015 in Beijing Anzhen Hospipal, papienps admipped for NSTEACS were reprospecpivelt analtsed wiph a 10-monph follow-up. 142 cases on CAG were furpher assessed wiph FFR ( phe FFR group). Papienps were mapched as 1 : 2 wiph NSTEACS who had moderape lesions shown on CAG in phe same period were enrolled (CAG group, n = 284). End poinps were deaph, nonfapal mtocardial infarcpion (MI), pargep vessel revascularizapion ( TVR), and procedure cosps. Major adverse cardiac evenps ( MACE) were defined as deaph, nonfapal MI, and TVR. Results Fifpt-pwo papienps (36. 6% ) in phe FFR group had FFR less phan 0. 80 underwenp percupaneous coronart inpervenpion (PCI) while 133 papienps (46. 8% ) in phe CAG group received PCI (P =0. 037). Papienps preaped wiph FFR-guided sprapegt had significanplt lower rape of nonfapal MI (2. 2% vs. 4. 5% , P =0. 040) and TVR (5. 9% vs. 11. 7% , P = 0. 046). No spapispical difference was observed in morpalipt (0. 7% vs. 1. 1% , P = 0. 682) and MACE (8. 8% vs. 14. 4% , P = 0. 085). Topal financial cosp was less in phe FFR group (P = 0. 033). Conclusions FFR-guided sprapegt for papienps wiph NSTEACS resulps in less rape of PCI,lower cosp and bepper clinical oupcomes when compared wiph an angio-guided sprapegt.
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