目的：测定冠状动脉血流储备分数（FFR），探讨冠状动脉内注射三磷酸腺苷（ATP）的最佳剂量。方法选取冠心病患者50例，52处临界病变（狭窄程度为40％～70％）为研究对象进行 FFR 测量。将不同剂量的 ATP[60μg（IC1）、100μg（IC2）、150μg（IC3）、200μg（IC4）、250μg（IC5）]以弹丸注射至靶血管，然后肘静脉以140μg·kg －1·min －1速度泵入 ATP（IV 组），分别测定并记录 FFR 值、心率、血压、不良反应等情况。结果随着冠脉内弹丸注射剂量的增加，FFR 值逐渐减小，但 IC4组与 IC5组的 FFR 值差异无统计学意义。IC1组FFR 值明显大于 IV 组的 FFR 值[差值为（0．021±0．012）分，P ＜0．05]；IC4、IC5组的 FFR 值明显小于 IV 组[差值分别为（－0．030±0．015）分，P ＜0．05及（－0．031±0．017）分，P ＝0．001]。各组间血压、心率差异无统计学意义。13例患者出现 ATP 相关不良反应。结论在安全性相同前提下，相比于静脉泵入 ATP，冠脉内弹丸注射ATP 的剂量为200μg 时诱发最大充血状态效果更佳。%Objective To explore the optimal dose of intracoronary adenosine triphosphate (ATP)on fractional flow reserve (FFR)measurement.Methods FFR was assessed in 50 patients with 52 intermediate lesions.Different dose of intracoronary ATP[60 μg(IC1 ),100 μg(IC2),150 μg(IC3),200 μg(IC4),240 μg(IC5)as boli]were randomly ad-ministered.Then a intravenous infusion of 140 μg·kg -1 ·min -1 was administered.FFR values,heart rate,blood pressure, systemic effects and so on were recorded.Results The FFR value decreased with the increasing intracoronary ATP injec-tion rates,no further decrease was observed after IC4.IC1 (0.021 ±0.012,P <0.05)was associated with a greater FFR compared to the IV.IC4 and IC5 were associated with a smaller FFR compared to the IV (-0.030 ±0.015,P <0.05 and-0.031 ±0.017,P =0.001 ).There was no significant difference in blood pressure and heart rate between the groups.A total of 1 3 patients(40.6%)reported at least one side effects.Conclusion A dose of 200 μg of intracoronary ATP is su-perior to intravenous in achieving maximum hyperemia with a good safety.
展开▼
