CAJ | 학술논문

目的：探讨踝臂指数（ABI）、趾臂指数（TBI）、低密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值（LDL-C/HDL-C）在冠状动脉疾病患者中的应用价值。方法纳入2011年10月-2013年2月于中国医科大学附属第一医院心内科住院治疗的160例患者，依据冠状动脉多层螺旋CT造影（CTA）检查结果将患者分为两组，其中对照组患者57例（冠状动脉狭窄程度≤25%），冠状动脉病变组患者103例（冠状动脉狭窄程度＞25%）。冠状动脉病变组患者中冠状动脉单支病变患者30例（单支病变组）、双支病变患者31例（双支病变组）、三支病变患者42例（三支病变组）；轻度病变组患者55例（冠状动脉狭窄程度≤50%）及中重度病变组患者48例（冠状动脉狭窄程度＞50%）。对入组患者行ABI、TBI、LDL-C/HDL-C检查，分析冠状动脉病变不同亚组间ABI、TBI、LDL-C/HDL-C水平变化及其对判断冠状动脉病变程度的价值。结果对照组与冠状动脉单支病变组、双支病变组、三支病变组间ABI、TBI呈降低趋势，LDL-C/HDL-C水平呈升高趋势，组间ABI、TBI、LDL-C/HDL-C水平比较，差异均有统计学意义（P＜0.05）；三支病变组与对照组、单支病变组ABI、TBI及LDL-C/HDL-C水平间比较，差异均有统计学意义（P＜0.05）；双支病变组与对照组ABI水平间比较，差异有统计学意义（P＜0.05）。对照组与冠状动脉狭窄轻度病变组、中重度病变组间ABI、TBI呈降低趋势，LDL-C/HDL-C水平呈升高趋势，组间ABI、TBI、LDL-C/HDL-C水平比较，差异均有统计学意义（P＜0.05）；中重度病变组与对照组ABI、TBI及LDL-C/HDL-C水平间比较，差异有统计学意义（P＜0.05）；中重度病变组与轻度病变组及轻度病变组与对照组ABI水平间比较，差异有统计学意义（P＜0.05）。结论 ABI能较好反应冠脉病变程度，ABI值越低冠脉狭窄越重，但并不能全面反映冠脉病变范围；LDL-C/HDL-C、TBI对冠脉病变的判断有一定意义，但不适用于准确评价冠脉病变程度及范围。目的：探討踝臂指數（ABI）、趾臂指數（TBI）、低密度脂蛋白膽固醇與高密度脂蛋白膽固醇比值（LDL-C/HDL-C）在冠狀動脈疾病患者中的應用價值。方法納入2011年10月-2013年2月于中國醫科大學附屬第一醫院心內科住院治療的160例患者，依據冠狀動脈多層螺鏇CT造影（CTA）檢查結果將患者分為兩組，其中對照組患者57例（冠狀動脈狹窄程度≤25%），冠狀動脈病變組患者103例（冠狀動脈狹窄程度＞25%）。冠狀動脈病變組患者中冠狀動脈單支病變患者30例（單支病變組）、雙支病變患者31例（雙支病變組）、三支病變患者42例（三支病變組）；輕度病變組患者55例（冠狀動脈狹窄程度≤50%）及中重度病變組患者48例（冠狀動脈狹窄程度＞50%）。對入組患者行ABI、TBI、LDL-C/HDL-C檢查，分析冠狀動脈病變不同亞組間ABI、TBI、LDL-C/HDL-C水平變化及其對判斷冠狀動脈病變程度的價值。結果對照組與冠狀動脈單支病變組、雙支病變組、三支病變組間ABI、TBI呈降低趨勢，LDL-C/HDL-C水平呈升高趨勢，組間ABI、TBI、LDL-C/HDL-C水平比較，差異均有統計學意義（P＜0.05）；三支病變組與對照組、單支病變組ABI、TBI及LDL-C/HDL-C水平間比較，差異均有統計學意義（P＜0.05）；雙支病變組與對照組ABI水平間比較，差異有統計學意義（P＜0.05）。對照組與冠狀動脈狹窄輕度病變組、中重度病變組間ABI、TBI呈降低趨勢，LDL-C/HDL-C水平呈升高趨勢，組間ABI、TBI、LDL-C/HDL-C水平比較，差異均有統計學意義（P＜0.05）；中重度病變組與對照組ABI、TBI及LDL-C/HDL-C水平間比較，差異有統計學意義（P＜0.05）；中重度病變組與輕度病變組及輕度病變組與對照組ABI水平間比較，差異有統計學意義（P＜0.05）。結論 ABI能較好反應冠脈病變程度，ABI值越低冠脈狹窄越重，但併不能全麵反映冠脈病變範圍；LDL-C/HDL-C、TBI對冠脈病變的判斷有一定意義，但不適用于準確評價冠脈病變程度及範圍。
목적：탐토과비지수（ABI）、지비지수（TBI）、저밀도지단백담고순여고밀도지단백담고순비치（LDL-C/HDL-C）재관상동맥질병환자중적응용개치。방법납입2011년10월-2013년2월우중국의과대학부속제일의원심내과주원치료적160례환자，의거관상동맥다층라선CT조영（CTA）검사결과장환자분위량조，기중대조조환자57례（관상동맥협착정도≤25%），관상동맥병변조환자103례（관상동맥협착정도＞25%）。관상동맥병변조환자중관상동맥단지병변환자30례（단지병변조）、쌍지병변환자31례（쌍지병변조）、삼지병변환자42례（삼지병변조）；경도병변조환자55례（관상동맥협착정도≤50%）급중중도병변조환자48례（관상동맥협착정도＞50%）。대입조환자행ABI、TBI、LDL-C/HDL-C검사，분석관상동맥병변불동아조간ABI、TBI、LDL-C/HDL-C수평변화급기대판단관상동맥병변정도적개치。결과대조조여관상동맥단지병변조、쌍지병변조、삼지병변조간ABI、TBI정강저추세，LDL-C/HDL-C수평정승고추세，조간ABI、TBI、LDL-C/HDL-C수평비교，차이균유통계학의의（P＜0.05）；삼지병변조여대조조、단지병변조ABI、TBI급LDL-C/HDL-C수평간비교，차이균유통계학의의（P＜0.05）；쌍지병변조여대조조ABI수평간비교，차이유통계학의의（P＜0.05）。대조조여관상동맥협착경도병변조、중중도병변조간ABI、TBI정강저추세，LDL-C/HDL-C수평정승고추세，조간ABI、TBI、LDL-C/HDL-C수평비교，차이균유통계학의의（P＜0.05）；중중도병변조여대조조ABI、TBI급LDL-C/HDL-C수평간비교，차이유통계학의의（P＜0.05）；중중도병변조여경도병변조급경도병변조여대조조ABI수평간비교，차이유통계학의의（P＜0.05）。결론 ABI능교호반응관맥병변정도，ABI치월저관맥협착월중，단병불능전면반영관맥병변범위；LDL-C/HDL-C、TBI대관맥병변적판단유일정의의，단불괄용우준학평개관맥병변정도급범위。
Objective To investigate the application values of ankle-brachial index (ABI), toe-brachial index (TBI) and ratio of LDL-C to HDL-C (LDL-C/HDL-C) in patients with coronary artery disease. Methods The patients (n=160) were chosen from the Department of Cardiovascular Diseases of the First Affiliated Hospital of China Medical University from Oct. 2011 to Feb. 2013, and divided into control group (n=57, severity of CAS≤25%) and CAS group (n=103, severity of CAS>25%) according to the outcomes of CTA. CAS group was further divided into single-vessel group (with single coronary vessel lesion, n=30), double-vessel group (with lesion of 2 coronary vessels, n=31), 3-vessel group (with lesion of 3 coronary vessels, n=42), mild-lesion group (n=55, CAS≤50%) and mid-severe-lesion group (n=48, CAS>50%). All patients were given examinations on ABI, TBI and LDL-C/HDL-C, and the changes of ABI, TBI and LDL-C/HDL-C and their values to estimating the severity of coronary artery lesion were analyzed in all groups. Results ABI and TBI had a descent trend and LDL-C/HDL-C had a ascent trend in control group, single-vessel group, double-vessel group and 3-vessel group, and comparison in ABI, TBI and LDL-C/HDL-C showed statistical difference (P<0.05). The comparison in ABI, TBI and LDL-C/HDL-C showed statistical difference among 3-vessel group, control group and single-vessel group (P<0.05). The comparison in ABI showed statistical difference between double-vessel group and control group (P<0.05). ABI and TBI had a descent trend and LDL-C/HDL-C had a ascent trend in control group, mild-lesion group and mid-severe-lesion group, and comparison in ABI, TBI and LDL-C/HDL-C showed statistical difference (P<0.05). The comparison in ABI, TBI and LDL-C/HDL-C showed statistical difference between mid-severe-lesion group and control group (P<0.05). The comparison in ABI showed statistical difference between mid-severe-lesion group and mild-lesion group and between mild-lesion group and control group (P<0.05). Conclusion ABI can reflect well the severity of coronary artery lesion, and the lower the ABI value, the severer the CAS, which, however, can not fully reflect the range of coronary artery lesion. ABI, TBI and LDL-C/HDL-C have some diagnosis values to coronary artery lesion but they are not suitable for reviewing the severity and range of coronary artery lesion.