CAJ | 학술논문

目的研究颈动脉内膜中膜厚度(IMT)联合踝臂指数(ABI)对冠心病的预测价值.方法选择2008至2010年在日照市人民医院住院并行冠状动脉造影或介入治疗患者194例,术前对其进行颈动脉内膜中膜厚度以及踝臂指数测量,血液生化检查,病史采集,并根据ABI≤0.90为阳性,ABI＞0.90为阴性,IMT≥0.9 mm为阳性,IMT＜ 0.9 mm为阴性,设定为两项指标均为阴性为A组,ABI阳性为B1组,阴性为B2组,IMT阳性为C1组,阴性为C2组,两项指标均为阳性者为D组,并根据冠状动脉造影结果得出各组冠心病发病率.结果 A组中冠心病发病率为9.1％,B1组为64.8％,B2组为29.9％,C1组为70.8％,C2组为28.4％,D组为89.1％,从以上结果中我们可以看出,踝臂指数阳性能较好预测冠心病发生(B1:64.8％比B2:29.9％,P＜0.05);颈动脉内膜中膜厚度对冠心病的预测也有重要意义(C1:70.8％比C2:28.4％,P＜0.05),两项指标均为阳性对冠心病的预测价值要高于单一项指标(D:89.1％比B1:64.8％,C1:70.8％,P＜0.05),且两项指标阴性对冠心病的排除价值也要高于单一项指标阴性者(A:9.1％比B2:29.9％,C2:28.4％,P＜0.01).结论联合应用ABI、IMT两项指标对冠心病的预测具有重要的临床意义.
목적 연구경동맥내막중막후도(IMT)연합과비지수(ABI)대관심병적예측개치.방법 선택2008지2010년재일조시인민의원주원병행관상동맥조영혹개입치료환자194례,술전대기진행경동맥내막중막후도이급과비지수측량,혈액생화검사,병사채집,병근거ABI≤0.90위양성,ABI＞0.90위음성,IMT≥0.9 mm위양성,IMT＜ 0.9 mm위음성,설정위량항지표균위음성위A조,ABI양성위B1조,음성위B2조,IMT양성위C1조,음성위C2조,량항지표균위양성자위D조,병근거관상동맥조영결과득출각조관심병발병솔.결과 A조중관심병발병솔위9.1％,B1조위64.8％,B2조위29.9％,C1조위70.8％,C2조위28.4％,D조위89.1％,종이상결과중아문가이간출,과비지수양성능교호예측관심병발생(B1:64.8％비B2:29.9％,P＜0.05);경동맥내막중막후도대관심병적예측야유중요의의(C1:70.8％비C2:28.4％,P＜0.05),량항지표균위양성대관심병적예측개치요고우단일항지표(D:89.1％비B1:64.8％,C1:70.8％,P＜0.05),차량항지표음성대관심병적배제개치야요고우단일항지표음성자(A:9.1％비B2:29.9％,C2:28.4％,P＜0.01).결론 연합응용ABI、IMT량항지표대관심병적예측구유중요적림상의의.
Objective To study the predictive value of ankle-brachial index (ABI) combined with the media thickness of carotid artery intima in coronary heart disease.Methods One hundred and ninety-four patients undergone the coronary angiography or percutaneous coronary intervention were recruited in our study from 2008 to 2010.The intima media thickness (IMT) of carotid artery and ABI were measured before operation.In addition,the hemostatic factors and history collection were also finished before operation.According to our study criterion,ABI ≤0.9 was defined as positive,ABI ＞ 0.9 was defined as negative,IMT≥0.9 mm was defined as positive,IMT ＜0.9 mm was defined as negative.The patients were divided into six groups:group A:the aboved two indicators were negative; group B1:ABI was positive; group B2:ABI was negative; group C1:IMT was positive; group C2:IMT was negative; group D:the aboved two indicators were all positive.The incidence of coronary heart disease (CHD) was confirmed according to the results of the coronary angiography.Results The incidence of CHD was 9.1％ in group A,64.8％ in group B1,29.9％ in group B2,70.8％ in group C1,28.4％ in group C2 and 89.1％ in group D.The abnormal ABI had better predictive value in CHD (B1:64.8％ versus B2:29.9％,P ＜0.05).IMT also had statistical significance in the predictive value of CHD (C1:70.8％ versus C2:28.4％,P ＜0.05),the positive predictive value of aboved two abnormal indicators in CHD was higher than that of one abnormal indicator (D:89.1％ versus B1:64.8％,C1:70.8％,P ＜0.05),In addition,the negative predictive value of two combined negative indicators was also higher than that of one negative indicator (A:9.1％ versus B2:29.9％,C2:28.4％,P ＜0.01).Conclusions The combined two indicators of ABI and IMT have an important clinical significance in the predictive value of CHD.