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临床上对冠状动脉疾病通常采用影像学诊断方法指导治疗,然而其只能反映病变几何特征而无法反映功能状态。本文探究冠脉狭窄形态学与功能学之间的相关性,以期提高影像学诊断的有效性。本研究共纳入39位患者55支狭窄血管,采用医学统计分析方法对冠脉血流储备分数(FFR)和狭窄率进行相关性分析,讨论冠脉优势型和狭窄位置因素对其相关性的影响。研究发现,按照冠脉狭窄位置和优势型进行分组后,冠脉右优势型的左前降支狭窄患者的冠脉FFR与狭窄率存在相关性(r≈0.79,P<0.000 1);分组后狭窄率诊断心肌缺血的准确性从70.9%提高到了82.8%(参考FFR<0.80),敏感度(从72.2%提高到78.6%)和特异性(从70.3%提高到86.7%)也有明显改善。研究提示,冠脉狭窄位置和优势型是FFR与狭窄率相关性的重要影响因素,依据影像学检查结果诊断心肌缺血时纳入考虑这两个因素将有助于提高诊断的有效性。
Clinical diagnosis of coronary artery disease is usually used to guide the treatment of imaging diagnosis, however, it can only reflect the geometric features of the lesion can not reflect the functional status. This article explored the correlation between coronary stenosis morphology and function in order to improve the effectiveness of imaging diagnosis. A total of 55 patients with stenotic vessels were enrolled in this study. The correlation between coronary flow reserve fraction (FFR) and stenosis rate was analyzed by medical statistical analysis. The effects of coronary predominance and stenosis on the correlation were also discussed . The study found that, according to coronary stenosis location and dominating group, right coronary coronary artery stenosis and right coronary artery FFR stenosis rate (r ≈ 0.79, P 0.0001); stenosis The diagnostic accuracy of myocardial ischemia improved from 70.9% to 82.8% (FFR <0.80), and sensitivity (from 72.2% to 78.6%) and specificity (from 70.3% to 86.7%) were also significantly improved. Research suggests that coronary stenosis location and dominance are important factors that influence the correlation between FFR and stenosis. The diagnosis of myocardial ischemia based on the results of imaging studies to consider these two factors will help to improve the diagnostic effectiveness.