中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
8期
1045-1047
,共3页
严山%田晓沂%张学锋%李江津
嚴山%田曉沂%張學鋒%李江津
엄산%전효기%장학봉%리강진
冠状动脉疾病%踝臂指数%冠状动脉
冠狀動脈疾病%踝臂指數%冠狀動脈
관상동맥질병%과비지수%관상동맥
Coronary disease%Ankle brachial index%Coronary artery
目的 探讨老年病患者踝臂指数与冠状动脉狭窄严重程度的相关性,评价踝臂指数对冠状动脉狭窄严重程度的预测价值.方法 选择2010年9月至2012年3月行冠状动脉造影的老年住院患者98例,其中男68例,女30例.根据踝臂指数分为踝臂指数≥0.9组(72例)和踝臂指数＜0.9组(26例).评价踝臂指数与SYNTAX评分的相关性、踝臂指数与不同病变支数的关系以及踝臂指数对3支或左主干病变的预测价值.结果 ①踝臂指数＜0.9组与踝臂指数≥0.9组的SYNTAX评分和左心室射血分数差异有统计学意义[SYNTAX评分:(26±8)分比(12±6)分,左心室射血分数:(46±9)％比(54±10)％,均P＜0.05].②Pearson直线相关分析结果显示,踝臂指数与SYNTAX评分呈负相关(r=-0.598,P=0.001),即踝臂指数越低,冠状动脉病变程度越重,狭窄程度越重.③冠状动脉造影结果显示无病变、单支病变、2支病变、3支或左主干病变患者例数分别为8、33、29、28例,踝臂指数分别为1.02 ±0.19、1.01 ±0.19、1.03±0.09、0.81 ±0.16.3支或左主干病变的踝臂指数低于无病变、单支病变和2支病变者,差异有统计学意义(P＜0.01)；无病变、单支病变、2支病变的踝臂指数差异无统计学意义(P＞0.05).④受试者工作特征(ROC)曲线下面积为0.748[95％置信区间(CI):0.668～0.829,P＜0.01],以踝臂指数＜0.9作为截断值预测3支或左主干病变具有较高的特异性(78.5％)和敏感性(67.6％).Logistic多元回归分析显示SYNTAX评分、踝臂指数＜0.9、左心室射血分数是预测3支或左主干病变的独立危险因素[SYNTAX评分:优势比(OR)=3.004,95％ CI:2.001 ～6.007,P=0.022；踝臂指数＜0.9:OR=1.624,95％ CI:1.091 ～3.067,P=0.035；左心室射血分数:OR=2.185,95％ CI:2.042～5.815,P=0.016].结论 老年冠心病患者踝臂指数与冠状动脉狭窄严重程度呈负相关,踝臂指数可能是预测冠状动脉病变严重程度的指标之一.
目的 探討老年病患者踝臂指數與冠狀動脈狹窄嚴重程度的相關性,評價踝臂指數對冠狀動脈狹窄嚴重程度的預測價值.方法 選擇2010年9月至2012年3月行冠狀動脈造影的老年住院患者98例,其中男68例,女30例.根據踝臂指數分為踝臂指數≥0.9組(72例)和踝臂指數＜0.9組(26例).評價踝臂指數與SYNTAX評分的相關性、踝臂指數與不同病變支數的關繫以及踝臂指數對3支或左主榦病變的預測價值.結果 ①踝臂指數＜0.9組與踝臂指數≥0.9組的SYNTAX評分和左心室射血分數差異有統計學意義[SYNTAX評分:(26±8)分比(12±6)分,左心室射血分數:(46±9)％比(54±10)％,均P＜0.05].②Pearson直線相關分析結果顯示,踝臂指數與SYNTAX評分呈負相關(r=-0.598,P=0.001),即踝臂指數越低,冠狀動脈病變程度越重,狹窄程度越重.③冠狀動脈造影結果顯示無病變、單支病變、2支病變、3支或左主榦病變患者例數分彆為8、33、29、28例,踝臂指數分彆為1.02 ±0.19、1.01 ±0.19、1.03±0.09、0.81 ±0.16.3支或左主榦病變的踝臂指數低于無病變、單支病變和2支病變者,差異有統計學意義(P＜0.01)；無病變、單支病變、2支病變的踝臂指數差異無統計學意義(P＞0.05).④受試者工作特徵(ROC)麯線下麵積為0.748[95％置信區間(CI):0.668～0.829,P＜0.01],以踝臂指數＜0.9作為截斷值預測3支或左主榦病變具有較高的特異性(78.5％)和敏感性(67.6％).Logistic多元迴歸分析顯示SYNTAX評分、踝臂指數＜0.9、左心室射血分數是預測3支或左主榦病變的獨立危險因素[SYNTAX評分:優勢比(OR)=3.004,95％ CI:2.001 ～6.007,P=0.022；踝臂指數＜0.9:OR=1.624,95％ CI:1.091 ～3.067,P=0.035；左心室射血分數:OR=2.185,95％ CI:2.042～5.815,P=0.016].結論 老年冠心病患者踝臂指數與冠狀動脈狹窄嚴重程度呈負相關,踝臂指數可能是預測冠狀動脈病變嚴重程度的指標之一.
목적 탐토노년병환자과비지수여관상동맥협착엄중정도적상관성,평개과비지수대관상동맥협착엄중정도적예측개치.방법 선택2010년9월지2012년3월행관상동맥조영적노년주원환자98례,기중남68례,녀30례.근거과비지수분위과비지수≥0.9조(72례)화과비지수＜0.9조(26례).평개과비지수여SYNTAX평분적상관성、과비지수여불동병변지수적관계이급과비지수대3지혹좌주간병변적예측개치.결과 ①과비지수＜0.9조여과비지수≥0.9조적SYNTAX평분화좌심실사혈분수차이유통계학의의[SYNTAX평분:(26±8)분비(12±6)분,좌심실사혈분수:(46±9)％비(54±10)％,균P＜0.05].②Pearson직선상관분석결과현시,과비지수여SYNTAX평분정부상관(r=-0.598,P=0.001),즉과비지수월저,관상동맥병변정도월중,협착정도월중.③관상동맥조영결과현시무병변、단지병변、2지병변、3지혹좌주간병변환자례수분별위8、33、29、28례,과비지수분별위1.02 ±0.19、1.01 ±0.19、1.03±0.09、0.81 ±0.16.3지혹좌주간병변적과비지수저우무병변、단지병변화2지병변자,차이유통계학의의(P＜0.01)；무병변、단지병변、2지병변적과비지수차이무통계학의의(P＞0.05).④수시자공작특정(ROC)곡선하면적위0.748[95％치신구간(CI):0.668～0.829,P＜0.01],이과비지수＜0.9작위절단치예측3지혹좌주간병변구유교고적특이성(78.5％)화민감성(67.6％).Logistic다원회귀분석현시SYNTAX평분、과비지수＜0.9、좌심실사혈분수시예측3지혹좌주간병변적독립위험인소[SYNTAX평분:우세비(OR)=3.004,95％ CI:2.001 ～6.007,P=0.022；과비지수＜0.9:OR=1.624,95％ CI:1.091 ～3.067,P=0.035；좌심실사혈분수:OR=2.185,95％ CI:2.042～5.815,P=0.016].결론 노년관심병환자과비지수여관상동맥협착엄중정도정부상관,과비지수가능시예측관상동맥병변엄중정도적지표지일.
Objective To observe the relation between ankle-brachial index (ABI)and the extent of coronary stenosis and evaluate the usefulness of ABI for predicting the extent of coronary stenosis in elderly coronary artery disease (CAD).Methods Ninety-eight consecutive patients (age ≥ 65) who underwent coronary angiography were studied.All patients underwent ABI evaluation and blood biochemical examination in addition to history collection.We analyzed the relation between ABI and SYNTAX score,and the difference of ABI among patients with no CAD,1-vessel,2-vessel CAD and 3-vessel or main trunk CAD.Results ABI was inversely correlated with SYN-TAX score.ABI reduced significantly(P ＜ 0.01) in patients with 3-vessel or left main lesion CAD.Among 1-vessel or 2-vessel CAD,there was no significant difference in ABI.The corresponding area under the receiver operating characteristic (ROC) curve in 3-vessel or main trunk CAD was (0.748,95 ％ CI:0.668-0.829,P ＜ 0.01).ABI ＜0.9 had relatively high specificity(78.5％) and sensitivity(67.6％) for predicting the presence of 3-vessel disease or left main trunk CAD.In multivariate logistic regression analysis,ABI ＜ 0.9 was the independent predictor for 3-vessel disease or left main trunk CAD after adjusting for other variables.Conclusion Old patients ABI is inversely and significantly correlated with the extent of coronary stenosis.ABI ＜ 0.9 has relatively high specificity and sensitivity for predicting the presence of 3-vessel or left main trunk CAD.
