CAJ | 학술논문

目的：研究臂－踝脉搏波传导速度（baPWV ）评估冠心病患者冠脉病变程度的临床价值。方法：选择我院206例冠心病患者，按照冠脉造影心脏外科与介入治疗狭窄冠脉研究评分（SYNTAX ）积分分为轻度组（74例， SYNTAX积分＜23分），中度组（72例， SYNTAX积分23～32分）和重度组（60例， SYNTAX积分＞32分）。并选择同期正常健康体检者80例为健康对照组。检测并比较各组baPWV、踝臂指数（ABI）与颈－股脉搏波传导速度（cfPWV）的差异。应用Pearson相关分析分析冠心病患者baPWV、cfPWV及ABI与SYNTAX积分的相关性；应用多元Logistic回归模型分析baPWV、cfPWV及ABI是否为SYNTAX积分的危险因素。结果：与健康对照组比较，轻度组，中度组和重度组baPWV [（1.2±0.3）m／s比（1.5±0.4）m／s比（1.8±0.6）m／s比（2.0±0.7）m／s]和cfPWV [（1.3±0.5）m／s比（2.5±0.7）m／s比（2.9±0.8）m／s比（3.4±0.7）m／s]均显著升高（ P＜0.05或＜0.01），且重度组＞中度组＞轻度组，两两比较有显著差异（ P均＜0.05）；ABI显著降低[（1.02±0.32）比（0.82±0.24）比（0.73±0.16）比（0.56±0.09）]，且重度组＜中度组＜轻度组，两两比较均有显著差异（P均＜0.05）。Pearson相关分析显示 baPWV、cfPWV 水平与SYNTAX积分显著正相关（ r＝0.613， P＝0.007及 r＝0.528， P＝0.023），而ABI水平与SYNTAX积分无相关性。多元Logistic回归分析表明糖尿病，高血压， baPWV及cfPWV是SYNTAX积分的危险因素（OR＝4.016～5.809， P＜0.05或＜0.01）。结论：baPWV检测能有效评估冠心病患者冠脉病变程度。
목적：연구비－과맥박파전도속도（baPWV ）평고관심병환자관맥병변정도적림상개치。방법：선택아원206례관심병환자，안조관맥조영심장외과여개입치료협착관맥연구평분（SYNTAX ）적분분위경도조（74례， SYNTAX적분＜23분），중도조（72례， SYNTAX적분23～32분）화중도조（60례， SYNTAX적분＞32분）。병선택동기정상건강체검자80례위건강대조조。검측병비교각조baPWV、과비지수（ABI）여경－고맥박파전도속도（cfPWV）적차이。응용Pearson상관분석분석관심병환자baPWV、cfPWV급ABI여SYNTAX적분적상관성；응용다원Logistic회귀모형분석baPWV、cfPWV급ABI시부위SYNTAX적분적위험인소。결과：여건강대조조비교，경도조，중도조화중도조baPWV [（1.2±0.3）m／s비（1.5±0.4）m／s비（1.8±0.6）m／s비（2.0±0.7）m／s]화cfPWV [（1.3±0.5）m／s비（2.5±0.7）m／s비（2.9±0.8）m／s비（3.4±0.7）m／s]균현저승고（ P＜0.05혹＜0.01），차중도조＞중도조＞경도조，량량비교유현저차이（ P균＜0.05）；ABI현저강저[（1.02±0.32）비（0.82±0.24）비（0.73±0.16）비（0.56±0.09）]，차중도조＜중도조＜경도조，량량비교균유현저차이（P균＜0.05）。Pearson상관분석현시 baPWV、cfPWV 수평여SYNTAX적분현저정상관（ r＝0.613， P＝0.007급 r＝0.528， P＝0.023），이ABI수평여SYNTAX적분무상관성。다원Logistic회귀분석표명당뇨병，고혈압， baPWV급cfPWV시SYNTAX적분적위험인소（OR＝4.016～5.809， P＜0.05혹＜0.01）。결론：baPWV검측능유효평고관심병환자관맥병변정도。
Objective:To study assessment value of brachial‐ankle pulse wave velocity (baPWV) for severity of coro‐nary disease in patients with coronary heart disease (CHD) .Methods :According to SYNTAX score of coronary an‐giography ,a total of 206 CHD patients from our hospital were divided into mild group (n=74 ,SYNTAX score <23 scores) ,medium group (n= 72 ,SYNTAX score 23~32 scores) and severe group (n= 60 ,SYNTAX score > 32 scores) .Another 80 healthy subjects undergoing physical examinations were selected as healthy control group during the same period .BaPWV ,ankle brachial index (ABI) and carotid -femoral pulse wave velocity (cfPWV) were measured and compared among all groups .Pearson correlation analysis was used to analyze the correlation among baPWV ,cfPWV ,ABI and SYNTAX score in CHD patients ;multi -factor Logistic regression model was used to analyze whether baPWV ,cfPWV and ABI were risk factors for SYNTAX scores .Results:Compared with healthy control group ,there were significant rise in baPWV [ (1.2 ± 0.3) m/s vs .(1.5 ± 0.4) m/s vs .(1.8 ± 0.6) m/s vs . (2.0±0.7)m/s]andcfPWV [ (1.3±0.5)m/svs.(2.5±0.7)m/svs.(2.9±0.8)m/svs.(3.4±0.7)m/s]in mild group ,medium group and severe group (P<0.05 or <0.01) ,and that of severe group was more than that of medium group ,and>mild group in turn ,there was significant difference by pairwise comparisons ( P<0.05 all);significant reduction in ABI [ (1.02 ± 0.32) vs .(0.82 ± 0.24) vs .(0.73 ± 0.16) vs .(0.56 ± 0.09)] in mild group , medium group and severe group ,and that of severe group was < medium group ,and < mild group in turn ,there was significant difference by pairwise comparisons ( P<0.05 all) .Pearson correlation analysis indicated that baPWV and cfPWV were positively correlated with SYNTAX score ( r= 0.613 , P= 0.007;r=0.528 , P=0.023) ,while ABI had no correlation with SYNTAX score .Multi-factor Logistic regression analysis indicated that diabetes melli‐tus ,hypertension ,baPWV and cfPWV were risk factors for SYNTAX score (OR=4.016~5.809 , P<0.05 or <0.01) .Conclusion:The baPWV can effectively assess severity of coronary disease in CHD patients .