摘要
目的 探讨不同民族间冠状动脉CT血流储备分数(CT-FFR)水平比较及其对中重度冠状动脉狭窄患者心血管不良事件的预测价值。方法 选取286例中重度冠状动脉狭窄患者,均行双源冠状动脉CT扫描,计算CT-FFR值。比较汉族、哈萨克族及维吾尔族中重度冠状动脉狭窄患者CT-FFR值。并对所有患者随访12个月,观察随访期间心血管不良事件发生情况,根据发生情况将患者分为发生组(65例)与未发生组(221例),比较两组CT-FFR值。采用多因素Logistic回归模型分析中重度冠状动脉狭窄患者心血管不良事件发生的影响因素;绘制受试者工作特征(ROC)曲线,分析CT-FFR值对中重度冠状动脉狭窄患者心血管不良事件的预测价值。结果 哈萨克族中重度冠状动脉狭窄患者CT-FFR值低于维吾尔族、汉族患者,维吾尔族患者低于汉族患者,差异有统计学意义(P<0.05);286例中重度冠状动脉狭窄患者中,共65例患者在随访期间发生心血管不良事件,发生率为22.73%。发生组CT-FFR值低于未发生组,狭窄程度为重度的患者占比高于未发生组,差异有统计学意义(P<0.05);ROC曲线分析显示CT-FFR值预测中重度冠状动脉狭窄患者心血管不良事件的曲线下面积为0.735(95%CI:0.675~0.795),最佳截断值为0.775。结论 哈萨克族CT-FFR值低于维吾尔族和汉族,维吾尔族CT-FFR值低于汉族。冠状动脉CT-FFR值可有效预测中重度冠状动脉狭窄患者心血管不良事件发生风险,且CT-FFR值低于0.775时,心血管不良事件发生风险更高。
Objective To explore the predictive value of coronary CT flow reserve score(FFR)for cardiovascular adverse events in patients with moderate to severe coronary stenosis.Methods 286 patients with moderate to severe coronary artery stenosis admitted were selected.All patients underwent dual source coronary CT scans and CT-FFR values were calculated.The CT-FFR levels of patients with moderate to severe coronary artery stenosis were compared among Han,Kazakh,and Uyghur ethnic groups.And all patients were followed up for 12 months to observe the occurrence of cardiovascular adverse events during the follow-up period.Patients were divided into an occurrence group(65 cases)and a non-occurrence group(221 cases)according to the occurrence.The CT-FFR values of the two groups were compared,and a multiple Logistic regression model was used to analyze the influencing factors of cardiovascular adverse events in patients with moderate to severe coronary stenosis.Receiver operating characteristic(ROC)curve was drawn and the predictive value of CT-FFR values for cardiovascular adverse events in patients with moderate to severe coronary stenosis were analyzed.Results The CT-FFR values of Kazakh patients with moderate to severe coronary artery stenosis were lower than those of Uyghur and Han patients,and Uyghur patients were lower than Han patients,with statistically significant differences(P<0.05).Among 286 patients with moderate to severe coronary artery stenosis,a total of 65 patients experienced cardiovascular adverse events during follow-up,with an incidence rate of 22.73%.The CT-FFR value in the occurrence group was lower than that in the non-occurrence group,and the proportion of patients with severe stenosis was higher than that in the non-occurrence group,with statistically significant differences(P<0.05).The ROC curve was plotted,and the results showed that the area under the curve(AUC)of CT-FFR value for predicting cardiovascular adverse events in patients with moderate to severe coronary stenosis was 0.735(95%CI:0.675-0.795),with an optimal cutoff value of 0.775.Conclusion Coronary CT-FFR values can effectively predict the risk of cardiovascular adverse events in patients with moderate to severe coronary stenosis,and the risk of cardiovascular adverse events is higher when the CT-FFR value is below 0.775.
作者
关伟锋
王艳丽
祝因苏
古丽米热木·叶海亚
陈菲菲
任月玲
GUAN Weifeng;WANG Yanli;ZHU Yinsu;GU LIMI REMU·Yehaiya;CHEN Feifei;REN Yueling(Imaging Center of Friendship Hospital,Yili Kazak Autonomous Prefecture 835000,China;Yili Institute of Clinical Medicine,Yili Kazak Autonomous Prefecture 835000,China;Department of Radiology,The First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China)
出处
《医学影像学杂志》
2025年第7期32-36,共5页
Journal of Medical Imaging
基金
新疆维吾尔自治区自然科学基金资助项目(编号:2024D01A133)
伊犁州临床医学研究院项目(编号:yl2020py12)。
关键词
体层摄影术
X线计算机
冠状动脉狭窄
血流储备分数
心血管不良事件
预测
Tomography,X-ray computed
Coronary artery stenosis
Fractional flow reserve
Cardiovascular adverse events
Prediction
