CAJ | 학술논문

目的：探讨血清同型半胧氨酸（HCY）、踝臂指数（ABI）、肱踝脉搏波传导速度（baPWV）对老年冠心病的诊断价值。方法97例行冠状动脉造影检查的患者根据造影结果分为冠心病组（65例）和非冠心病组（32例）。65例冠心病患者中单支病变组24例、双支病变组21例、多支病变组20例。比较各组基本临床指标（年龄、性别构成、TC、TG、LDL-C、HDL-C）、血 HCY、ABI、baPWV 水平。结果冠心病组中双支病变组、多支病变组在年龄上显著大于单支病变组（t ＝3．721、3．927，P ＜0．05）。余各指标在各组间差异均无统计学意义（均 P ＞0．05）。冠心病组 HCY、ABI、baPWV 平均水平分别为（18．29±2．73）μmol／L、（0．97±0．16）、（16．38±1．27）m／s，与非冠心病组相关指标的差异均有统计学意义（HCY：t ＝5．701，P ＜0．01；ABI：t ＝6．138， P ＜0．01；baPWV：t ＝15．132，P ＜0．01）。各组比较，冠心病组中单支病变组与非冠心病组在 ABI 上差异无统计学意义（均 P ＞0．05），而多支病变组、双支病变组在 ABI 上均显著低于非冠心病组（均 P ＜0．01）。冠心病各组 HCY、baPWV 水平均显著高于非冠心病组（均 P ＜0．01），随冠脉病变累及支数的增加，血 HCY、baPWV呈增高趋势，ABI 呈降低趋势（均 P ＜0．01）。结论HCY、baPWV、ABI 三者联合检测对老年冠心病的早期发现及早期干预具有重要价值。
목적：탐토혈청동형반롱안산（HCY）、과비지수（ABI）、굉과맥박파전도속도（baPWV）대노년관심병적진단개치。방법97례행관상동맥조영검사적환자근거조영결과분위관심병조（65례）화비관심병조（32례）。65례관심병환자중단지병변조24례、쌍지병변조21례、다지병변조20례。비교각조기본림상지표（년령、성별구성、TC、TG、LDL-C、HDL-C）、혈 HCY、ABI、baPWV 수평。결과관심병조중쌍지병변조、다지병변조재년령상현저대우단지병변조（t ＝3．721、3．927，P ＜0．05）。여각지표재각조간차이균무통계학의의（균 P ＞0．05）。관심병조 HCY、ABI、baPWV 평균수평분별위（18．29±2．73）μmol／L、（0．97±0．16）、（16．38±1．27）m／s，여비관심병조상관지표적차이균유통계학의의（HCY：t ＝5．701，P ＜0．01；ABI：t ＝6．138， P ＜0．01；baPWV：t ＝15．132，P ＜0．01）。각조비교，관심병조중단지병변조여비관심병조재 ABI 상차이무통계학의의（균 P ＞0．05），이다지병변조、쌍지병변조재 ABI 상균현저저우비관심병조（균 P ＜0．01）。관심병각조 HCY、baPWV 수평균현저고우비관심병조（균 P ＜0．01），수관맥병변루급지수적증가，혈 HCY、baPWV정증고추세，ABI 정강저추세（균 P ＜0．01）。결론HCY、baPWV、ABI 삼자연합검측대노년관심병적조기발현급조기간예구유중요개치。
Objective To investigate the diagnostic value of blood homocysteine,ankle -brachial index and brachial -ankle pulse wave velocity in elderly patients with coronary heart disease (CHD).Methods 97 patients with routine coronary angiography were classified into CHD group (65 cases)and non -CHD group (32 cases) according to the results of coronary angiography.There were 24 cases with single -vessel disease in 65 CHD cases, 21 cases with double -vessel disease and 20 patients with multivessel disease of CHD.Basic clinical parameters,age, gender,TC,TG,LDL -C,HDL -C,etc and blood HCY,ABI,baPWV levels were compared among groups.Results The age of double -vessel disease group,multivessel disease group was significantly higher than that in single -vessel disease group(t =3.721,3.927,all P <0.05).HCY,ABI,baPWV in CHD group were (18.29 ±2.73)μmol/L, (0.97 ±0.16),(16.38 ±1.27)m/s,which had statistically significant differences compared with non -CHD group (HCY:t =5.701,P <0.01;ABI:t =6.138,P <0.01;baPWV:t =15.132,P <0.01 ).There were no significant differences between single -vessel disease group and non -CHD group on the ABI(all P >0.05),and the ABI of multi -vessel disease,double vessel disease group were significantly lower than that of non -CHD group (all P <0.01).HCY,baPWV of CHD group were significantly higher than non -CHD group(all P <0.01 ),double vessel disease,HCY multivessel disease group,ABI,baPWV average water with single -vessel disease group were signifi-cantly different(all P <0.01 ).With the increase of coronary lesions involved,the blood HCY,baPWV showed an increasing trend and ABI showed an decreasing trend.Conclusion Combined detection of HCY,baPWV and ABI has great value in early detection and early intervention of CHD in the elderly.