Objective To study the value of ankle-brachial index(ABI) and carotid intima-media thickness(IMT) for the assessment of coronary heart disease(CHD) and its related risk factors in postmenopausal women. Methods One hundred and eighty-seven postmenopausal women with suspicious CHD were divided into non-CHD group(n = 66) and CHD group(n = 121) according to their coronary angiographic findings. The CHD group was further divided into single lesion group (n= 40) ,double lesion group(n = 40) and multiple lesion group(rc = 41). Severity of coronary artery lesions was assessed with the Gensini integral system. ABI,carotid IMT and related indications in different groups were detected and compared. Results The rate of detected carotid IMT and plaques increased significantly while the ABI decreased significantly with the severity of CHD. Logistic regression analysis showed that low ABK≤O. 9) ,high IMTC≥S0. 9 mm) .constipation, age, diabetes, hypertension, and high serum levels of cholesterol,uric acid,and sensitive C-re-active protein were the independent risk factors for CHD in postmenopausal women. Conclusion ABI and carotid IMT can be used as noninvasive predictors of CHD and constipation is an independent risk factor for CHD in postmenopausal women.%目的 探讨臂踝指数(ABI)和颈动脉内膜中层厚度(IMT)对绝经后女性冠心病的评价价值及绝经后女性发生冠心病的相关危险因素.方法 选择疑诊冠心病的绝经后女性患者187例,根据冠状动脉造影结果分为非冠心病组66例和冠心病组121例；冠心病组又分为单支病变组40例、双支病变组40例、多支病变组41例.通过Gensini积分系统评价冠状动脉病变程度.检测各组患者ABI、IMT及相关指标,并进行比较.结果 与非冠心病组比较,冠心病组IMT明显增厚,ABI明显降低,差异有统计学意义(P＜0.05).随着冠状动脉病变程度加重,ABI明显降低,IMT及斑块检出率也明显增高.logistic回归分析显示,ABI降低(≤0.9)、IMT增厚(≥0.9 mm)是绝经后女性冠状动脉病变的独立预测因素,便秘为独立危险因素.其他危险因素:年龄、糖尿病、高血压、高胆固醇血症、高尿酸、高敏C反应蛋白升高等可以增加绝经后女性患冠心病的风险.结论 ABI及IMT可以作为绝经后女性冠状动脉病变的无创性预测指标.便秘可作为绝经后女性冠心病的独立危险因素.
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