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目的 评价血流储备分数（FFR）指导下功能性完全血运重建对非ST段抬高型心肌梗死（NSTEMI）并发多支病变患者短期预后的影响。方法 选取西京医院心血管内科95例NSTEMI并发多支病变患者为功能性完全血运重建组(冠脉造影狭窄>90%的病变直接行PCI治疗，对狭窄70%~90%的病变行FFR检查，FFR<0.75为PCI治疗的指征)，同时期冠脉造影指导下完全血运重建的患者为对照(解剖学完全血运重运组)组（狭窄≥70%且直径>2.5mm的病变常规行PCI治疗）。患者随访12个月，比较两组患者主要不良心血管事件（MACE）及再发心绞痛、因冠心病再住院发生情况和左室射血分数(LVEF)的变化。结果 与对照组比较，功能性完全血运重建组再发心绞痛〔9% vs. 30%,P<0.01〕、因冠心病再住院〔5% vs. 19%,P<0.01〕及MACE〔9% vs. 22%,P<0.05〕发生率均显著降低；两组LVEF均较术前增加〔(60±7)% vs.(56±8)%〕，功能性完全血运重建组增加显著(均P<0.05)。结论 FFR指导下功能性完全血运重建能降低患者12个月MACE发生率，减少再发心绞痛、因冠心病再住院次数，改善患者左心功能，患者近期获益明显。
Objective To evaluate the short-term prognosis of patients with non-ST-segment elevation myocardial infarction (NSTEMI) complicated with multi-vessel disease under the guidance of FFR. Methods Ninety-five patients with NSTEMI complicated with multivessel disease under Xijing Hospital were enrolled in the functional complete revascularization group (coronary angiography stenosis> 90% of the lesions were directly treated with PCI, FFR was performed in 70% ~ 90% of the stenosis, FFR & lt; 0.75 for the indication of PCI), while patients undergoing complete revascularization guided by coronary angiography at the same time were in the control (anatomic complete revascularization) group (stenosis ≥70% and diameter & gt; 2.5 mm Of the lesions routine PCI treatment). The patients were followed up for 12 months. The major adverse cardiovascular events (MACE) and recurrence of angina were compared between the two groups. The incidence of rehospitalization due to coronary heart disease and left ventricular ejection fraction (LVEF) were also compared. Results Compared with the control group, patients with functional complete revascularization had recurrent angina (9% vs. 30%, P <0.01), hospitalized patients with coronary heart disease (5% vs. 19%, P <0.01) % vs. 22%, P & lt; 0.05]. The LVEF in both groups was significantly higher than that before the operation [(60 ± 7)% vs. (56 ± 8)%] (All P & lt; 0.05). Conclusion Functional complete revascularization under the guidance of FFR can reduce the incidence of MACE at 12 months and reduce the recurrence of angina. The number of re-hospitalizations for coronary heart disease and the improvement of left ventricular function in patients with coronary artery disease have shown significant benefits in recent years.