快速傅里叶变换分析冠状动脉旁路移植术中不同桥血管的血流波形特征及其意义

doi:10.13481/j.1671-587X.20210524

摘要/Abstract

摘要： 目的

基于血流频谱特征探讨冠状动脉旁路移植术（CABG）中左侧乳内动脉（LIMA）、大隐静脉（SVG）、乳内动脉+大隐静脉复合桥（LIMA+SVG）和桡动脉（RA）术后通畅率上存在差异的原因，阐明其临床意义及应用价值。

方法

收集132例行CABG患者的临床资料，获取术后随访中未病变桥血管的血流波形，按照桥血管类型分为LIMA组、SVG组、LIMA+SVG组和RA组，分别进行快速傅里叶变换（FFT），通过统计学方法比较各组桥血管频谱中各波峰（按频率由低至高命名为H₁~H_n）的频率和幅度值的差异，分析不同种类桥血管远期通畅率差异的影响因素。

结果

LIMA组与SVG组患者第一谐波H₁频率相等，LIMA组其他谐波频率小于SVG组。LIMA+SVG组H₁和H₂频率高于LIMA组，H₃频率小于LIMA组，且LIMA+SVG组可见第四谐波差异（H₄）。与SVG组比较，LIMA+SVG组H₁频率更高，H₂和H₃频率更低。RA组H₁和H₂频率较LIMA组及SVG组均更高。4组血管幅度值比较差异有统计学意义（χ²=8.131，P=0.043），SVG组血管幅度值高于LIMA组（P=0.006），LIMA+SVG组和RA组血管幅度值与LIMA组比较差异无统计学意义（P=0. 812，P=0.977）。

结论

LIMA和RA桥血管内血液流动更平稳，不易形成湍流，是CABG术中的优先选择；LIMA+SVG具有一定的动脉特征，在结构上较SVG有一定优势；SVG内血流最容易形成湍流，应尽可能减少使用。

关键词: 冠状动脉旁路移植术, 通畅率, 术中瞬时流量测定, 快速傅里叶变换

Abstract: Objective

To explore the reasons for the differences in the patency rates of left internal mammary artery （LIMA）， great saphenous vein （SVG）， internal mammary artery + great saphenous vein composite bridge （LIMA+SVG） and radial artery （RA） after coronary artery bypass grafting （CABG） based on the characteristics of blood flow spectrum， and to clarify the clinical significance and application value.

Methods

The clinical materials of 132 patients underwent CABG were collected. The blood flow waveforms of patent grafts in follow-up were obtained and divided into LIMA group， SVG group， LIMA+SVG group and RA group according to the types for Fast Fourier Transform （FFT）. The differences in the frequencies and amplitudes of wave peaks （which were named H₁－H_n according to frequency from low to high） in the spectrum of grafts in various groups were compared with the statistic method and the factors affecting the differences in the long-term patency rates of different types of grafts were analyzed.

Results

The frequency of first harmonic （H₁） in LIMA group was equal to SVG group， and the others in LIMA group were lower than those in SVG group. The frequencies of H₁ and H₂ in LIMA +SVG group were higher than those in LIMA group， the frequency of H₃ was lower， and the fourth harmonic H₄ was visible. Compared with SVG group， the frequency of H₁ in LIMA+SVG group and the frequencies of H₂ and H₃were lower.The frequencies of H₁ and H₂ in RA group were higher than those in LIMA group and SVG group.The differences in the amplitudes between four groups were statistically significant （χ²=8.131， P=0.043）；the amplitude in SVG group was higher than that in LIMA group （P=0.006），and there were no significant differences in the amplitudes between LIMA+SVG group， RA group and LIMA group （P=0.812， P=0.977）.

Conclusion

The blood flow in LIMA and RA is more stable and less turbulent， which are the preferred choice in CABG operation. LIMA+SVG has partly arterial characteristics and the structural advantages compared with SVG. The flow of SVG is easier to turbulence and SVG should be reduced as much as possible.

Key words: coronary artery bypass grafting, patency rate, transit-time flow measurement in operation, Fast Fourier transform

中图分类号:

R654.2

贾彦雄,高杰,苏丕雄. 快速傅里叶变换分析冠状动脉旁路移植术中不同桥血管的血流波形特征及其意义[J]. 吉林大学学报(医学版), 2021, 47(5): 1250-1257.

Yanxiong JIA,Jie GAO,Pixiong SU. Characteristics of blood flow waveform of different grafts in coronary artery bypass grafting based on Fast Fourier transform and their significances[J]. Journal of Jilin University(Medicine Edition), 2021, 47(5): 1250-1257.

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Variable	n	LIMA	SVG	LIMA+SVG	RA	P
Age (year)		61.73±8.84	62.41±7.97	62.64±5.64	62.00±9.54	0.778
BMI(kg·m^－2)		25.21±3.50	25.03±3.42	24.04±0.95	26.10±4.25	0.635
Male (n)	98	76	155	8	3	0.791
Smoking (n)	74	58	120	6	3	0.517
Diabetes mellitus (n)	55	42	82	4	0	0.365
Hypertension (n)	83	68	137	2	1	0.358
Hyperlipemia (n)	90	73	148	8	2	0.998
Chronic renal insufficiency (n)	3	2	5	0	0	0.875
PVD (n)	8	4	10	1	0	0.846
Previous cerebrovascular accidents (n)	18	12	26	1	0	0.819
Previous MI (n)	35	25	25	5	1	0.405
Previous PCI (n)	24	16	34	3	0	0.586
The statistical unit was grafts. Continuous variables with normal distribution were presented as x±s unless otherwise noted. Counting variables were presented as person-time（n）.PVD： Peripheral vascular disease；MI： Myocardial infarction.

Group	Project	H₀	H₁	H₂	H₃	H₄
LIMA	Frequency（Hz）	0	2.500	3.750	6.250	－
LIMA	Amplitude value	34.52	2.11	1.14	0.88	－
SVG	Frequency（Hz）	0	2.500	5.625	8.125	－
SVG	Amplitude value	50.66	4.54	3.88	2.12	－
LIMA+SVG	Frequency（Hz）	0	3.125	4.375	5.625	8.750
LIMA+SVG	Amplitude value	36.75	2.57	2.18	0.80	1.60
RA	Frequency（Hz）	0	3.125	6.250	－	－
RA	Amplitude value	33.55	2.64	1.98	－	－
LIMA：Left internal mammary artery； SVG：Saphenous vein graft； RA： Radial artery.“－”：No data.

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