法 第二十章 专利权的主体.ppt

瞬时无波形比值评价冠状动脉狭窄的临床研究进展 天津市第一中心医院 国际诊疗中心 300192 荣玉栋 蔡林 王小飞 摘要：目前指导冠心病的介入治疗已经进入冠状动脉狭窄病变的生理学评估的功能学时代。通过生理学指标评价冠状动脉病变的严重程度、对心肌供血的影响做出更为准确的评估，从而进一步指导临床决策的制定。循证医学已经证实了血流储备分数 (fractional flow reserve, FFR)评价缺血性冠心病患者冠状动脉狭窄病变功能的临床价值。FFR相似，瞬时无波形比值 (instantaneous wave-free ratio，iFR) 是一个不需要应用冠状动脉血管扩张药物评价冠状动脉血管狭窄严重程度的新的生理学压力指标。近年来iFR的研究不断深入，本文将对其临床研究进展做一综述。 关键词：冠脉循环；血流储备分数；瞬时无波形比值 The clinical research progress of the evaluation of the coronary artery stenosis with the instantaneous wave-free ratio RONG Yu-Dong , CAI Lin, WANG Xiao‐Fei（International Medical Center，Tianjin first Central Hospital，Tianjin 300192，China） Corresponding author：RONG Yu-Dong，Email：ydrong2001@163.com Abstract: at present, interventional treatment of coronary heart disease has entered the era of the function of the physiological evaluation of coronary artery stenosis. The evaluation of the severity of coronary artery stenosis and the effect of the coronary artery stenosis to myocardial blood supply by the physiological index was made more accurate, so as to further guide the clinical decision making. Evidence based medicine has confirmed the clinical value of flow reserve fractional (FFR) in evaluating the function of coronary artery stenosis in patients with ischemic coronary artery disease. Similar to FFR, the instantaneous wave ratio (iFR) is a new physiological pressure indicator to evaluation the severity of coronary artery stenosis which does not require the coronary vasodilator. In recent years, the research of iFR is unceasingly thorough, this article will make a summary to its clinical research progress. Key Words: Coronary circulation; Fractional flow reserve; Instantaneous wave-free ratio 新近研究显示，一种不需要腺苷等血管扩张药物这项新的技术的心血管病患者，是那些腺苷等血管扩张药物的患者。FFR已经成为稳定性缺血性冠心病患者冠状动脉狭窄病变功能性评价，循证医学依据它的临床价值。压力导丝测量技术不断的改进wave-intensity）分析的引入，研究者通过波强度分析发现：从主动脉产生的向远端传播的血流压力和起自远端微循环的血流压力相互作用[4,5]，这种竞争性的相互作用出现在整个心脏收缩期，而微循环波在心脏舒张早期达到最大。进一步研究发现在舒张期内存在某一特定时期，在此短暂时间内微循环波呈静止状态，即所谓瞬时无波期（instantaneous wave-free period）。与其他心动周期相比