摘要
目的探讨脉搏波传导速度(PWV)、踝臂指数(ABI)、趾臂指数(TBI)存不同类型冠心病患者中的差异以及与SYNTAX评分的关系,分析其在冠心病诊断中的价值。方法纳入402例经介入治疗的冠心病患者,分为稳定型心绞痛组、不稳定型心绞痛组、急性心肌梗死组,体检正常的81人作为正常对照组。依据SYNTAX评分,将冠心病患者又分为SYNTAX评分轻度、中度、重度组。比较不同类型冠心病组与正常对照组的PWV、ABI、TBI的差异,比较冠心病不同SYNTAX评分组的PWV、ABI、TBI的差异并分析与SYNTAX评分的相关性。结果与正常对照组比较,不同类型冠心病PWV值均升高,P<0.05,差异有统计学意义;急性心肌梗死组TBI、ABI值低于正常对照组,P<0.05,差异有统计学意义。PWV与SYNTAX评分呈正相关(r=0.187,P<0.05),TBI与SYNTAX评分呈负相关(r=-0.084,P<0.05),TBI与SYNTAX评分呈负相关(r=-0.193,P<0.01)。急性心肌梗死患者SYNTAX评分重度组和中度组PWV值高于轻度组(P<0.05);SYNTAX评分重度组TBI、ABI值高于中度组和轻度组(P<0.05)。不稳定型心绞痛患者SYNTAX评分重度组PWV值高于中度组和轻度组,中度组PWV值高于轻度组(均P<0.05);SYNTAX评分重度组TBI、ABI低于轻度组(P<0.05)。稳定型心绞痛患者SYNTAX评分重度组PWV值高于轻度组和中度组(均P<0.05);SYNTAX评分重度组ABI值低于轻度组(P<0.05)。结论 PWV对不同类型冠心病的SYNTAX评分的预测(即冠状动脉病变的解剖及严重的程度判断)具有一定的临床价值;ABI、TBI对冠心病的诊断无临床价值,对不同类型冠心病患者的病变解剖及病变程度的临床指导价值不如PWV。
Objective To explore the difference of the pulse wave velocity （PWV）, ankle brachial index （ABI） and toe brachial index （TBI） among the patients with different types of coronary heart disease, and the relationship between SYNTAX score with PWV, ABI, and TBI, and analyze their values on the diagnosis of coronary heart disease. Methods 402 coronary heart disease patients undergoing interventional therapy were divided into stable angina group, unstable angina group, acute myocardial infarction group and 81 healthy people as normal control group. According to SYNTAX score, the coronary heart disease patients were divided into mild, moderate and severe group. Compare the differences in PWV, TBI, ABI between different types of coronary heart disease group and normal control group and among the different syntax score groups, and analyze the their correlations with SYNTAX score. Results Compared with the normal control group, the PWV in different groups of coronary heart disease was increased with statistically significant difference, P 〈 0.05. TBI and ABI in acute myocardial infarction group were significantly lower than those in normal control group, P 〈 0.05. SYNTAX scores were positively correlated with PWV （r =0.187, P 〈 0.05）, and negatively correlated with ABI （r = -0.084, P 〈 0.05）, and negatively correlated with TBI （r = -0.193, P 〈 0.01）. In acute myocardial infarction group, PWVs in severe SYNTAX score group and moderate SYNTAX score group were significa1~tly higher than one in the mild SYNTAX score group, P 〈 0.05. TBI, ABI in severe SYNTAX score group were higher than those in the moderate group and mild group with significant difference, P 〈 0.05. In unstable angina group, PWV in severe SYNTAX score group was significantly higher than that in the moderate group and mild group, PWV in moderate SYNTAX score group was significantly higher than that in the mild group, all P 〈 0.05. ABI, TBI in severe SYNTAX score group were lower than that in the mild group with significant difference, P 〈 0.05. In stable angina group, PWV in severe SYNTAX score group was significantly higher than that in mild group and moderate group, P 〈 0.05. ABI in severe SYNTAX score group was significantly lower than that in the mild group, P 〈 0.05. Conclusion PWV have a certain clinical value in SYNTAX score prediction of different types of coronary artery disease （identification of anatomy and severity of coronary artery atherosclerosis）; and TBI, ABI have no clinical value in the diagnosis of coronary heart disease, the clinical value is not as goodas PWV.
出处
《兰州大学学报（医学版）》
CAS
2016年第2期28-32,37,共6页
Journal of Lanzhou University（Medical Sciences）
基金
十二五国家科技支撑计划项目(2011BAI11B08)
关键词
冠心病
脉搏波传导速度
踝臂指数
趾臂指数
SYNTAX评分
coronary heart disease
pulse wave velocity
ankle brachial index
toe brachial index
SYNTAX score index
