摘要
目的探讨血流储备分数(Fractional flow reserve,FFR)指导下的经皮球囊肺动脉腔内成形术(Balloon dilation of the pulmonary angioplasty,BPA)治疗慢性血栓栓塞性肺动脉高压(Chronic thromboembolic pulmonary arterial hypertension,CTEPH)患者的临床效果,并探讨其对随访半年疗效的影响。方法入选2018年8月至2024年12月于我中心FFR指导下行BPA治疗的CTEPH患者40例设为观察组,30例未使用FFR指导而采用传统肺动脉造影指导行BPA治疗的CTEPH患者设为对照组。收集受试者的一般临床资料;右心导管检查获得肺血管血流动力学相关参数;心脏彩超获得肺动脉压相关数据。分析WHO功能分级、6分钟步行试验距离(6-minute walking distance,6-MWD)、血浆氨基末端B型脑利钠肽前体(NT-proBNP)、肺血管血流动力学相关参数及心脏超声肺动脉压相关数据等各指标的变化。分析FFR指导下行BPA治疗对BPA疗效的影响。结果观察组较对照组比较,观察组WHO功能分级改善程度、6-MWD、NT-proBNP改善程度显著优于对照组(均P<0.05);右心导管指标改善程度优于对照组(均P<0.05);心脏彩超肺动脉压相关数据改善程度优于对照组(均P<0.05);二元Logistic回归分析显示FFR指导下的BPA术是BPA治疗CTEPH疗效的影响因素。结论FFR指导下的BPA术在治疗CTEPH患者中较传统肺动脉造影指导下的BPA术具有更好的临床疗效,是BPA疗效的影响因素,因此FFR指导下行BPA治疗CTEPH可能会得到更优的临床效果,为CTEPH的精准治疗提供依据。
Objective To investigate the clinical outcomes of Percutaneous balloon pulmonary angioplasty(BPA)guided by Fractional Flow Reserve(FFR)in the treatment of patients with Chronic Thromboembolic Pulmonary Hypertension(CTEPH),and to explore its impact on therapeutic efficacy.Methods Forty patients with CTEPH who underwent BPA treatment guided by FFR at our center from August 2018 to December 2024 were selected as the observation group,while thirty patients with CTEPH who underwent BPA treatment guided by traditional pulmonary angiography without FFR were selected as the control group.General clinical data of the participants were collected;right heart catheterization was performed to obtain hemodynamic parameters related to pulmonary vasculature;and echocardiography was used to acquire data related to pulmonary artery pressure.Changes in various indicators,including WHO functional classification 6-minute walking distance(6-MWD),plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP),hemodynamic parameters related to pulmonary vasculature,and echocardiographic data related to pulmonary artery pressure were analyzed.The impact of BPA treatment guided by FFR on the efficacy of BPA was evaluated.Results Compared to the control group,the observation group demonstrated significantly greater improvement in WHO functional class,6-MWD,and NT-proBNP levels(all P<0.05).The improvement in right heart catheterization parameters was also superior to that of the control group(all P<0.05).Similarly,echocardiographic parameters related to pulmonary arterial pressure showed significantly better improvement in the observation group(all P<0.05).Binary logistic regression analysis indicated that FFR-guided BPA procedure was a protective factor influencing the efficacy of BPA treatment in CTEPH patients.Conclusion The BPA procedure guided by FFR has better clinical efficacy than the traditional BPA procedure guided by pulmonary angiography in treating patients with CTEPH.It is an influencing factor for the efficacy of BPA.Therefore,performing BPA treatment for CTEPH under FFR guidance may lead to better clinical outcomes,providing a basis for the precise treatment of CTEPH.
作者
郑卫峰
王皓
ZHENG Weifeng;WANG Hao(Department of Cardiology,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang,Henan 471000,China)
出处
《临床肺科杂志》
2026年第1期36-41,共6页
Journal of Clinical Pulmonary Medicine
基金
河南省自然科学基金(232300420247)。
关键词
血流储备分数
经皮球囊肺动脉成形术
慢性血栓栓塞性肺动脉高压
疗效
Fractional Flow Reserve
Balloon Pulmonary Angioplasty
Chronic Thromboembolic Pulmonary Arterial Hypertension
Efficacy
