肱－踝脉搏波传导速度和踝臂指数对冠状动脉疾病的预测价值

摘要

Objective To explore whether brachial-ankle pulse wave velocity( baPWV) and ankle brachial index ( ABI) can be a useful approach to prediction of coronary artery disease ( CAD) in symptomatic patients.Methods Coronary angiog-raphy,ABI and baPWV were measured in 472 patients with typical pain or suspected CAD.BaPWV over 1400 cm/s and ABI<0.9 were defined as risk factors respectively.Results The ratio of baPWV>1400 cm/s was higher in patients with CAD than those without (P<0.001),but there was no difference about ABI<0.9 in the two groups.In multivariable logistic re-gression analysis,typical chest pain, BaPWV>1400 cm/s and diabetes remained independent predictors of the presence of CAD (OR:8.442,95%CI:5.063~14.077,OR:5.507, 95%CI:3.401~8.897,OR:3.027, 95% CI:1.854~4.941,P<0.001,respectively).Conclusion BaPWV over 1400 cm/s is a useful approach to prediction of CAD in symptomatic pa-tients.%目的：探讨肱－脉搏波传导速度及踝臂指数对冠状动脉疾病的预测价值。方法入选472例疑似冠状动脉粥样硬化性心脏病（ CAD）的患者，根据CAG的结果，分为非CAD组（冠状动脉管腔狭窄＜5％）和CAD组（冠状动脉管腔狭窄≥50％）。收集患者的基线资料，对所有患者进行肱－踝脉搏波传导速度（ BaPWV）及踝臂指数（ ABI）的测量。用Logistic回归模型评价BaPWV、ABI及其他相关指标对冠状动脉病变程度的预测能力。结果（1）糖尿病、BaPWV＞1400 cm／s、典型胸痛，2组比较差异有统计学意义（P值均＜0．001）；ABI＜0．9，2组比较无统计学差异（P＞0．05）。（2）Logistic多因素回归分析显示，典型胸痛症状，PWV＞1400 cm／s和糖尿病史为CAD的独立预测因子（P值均＜0．001）。 OR值分别为8．442（95％可信区间5．063～14．077），5．507（95％可信区间3．401～8．897），3．027（95％可信区间1．854～4．941）。结论典型胸痛症状、PWV＞1400 cm／s和糖尿病病史是预测CAD的有效因素之一，BaP－WV作为无创伤检查方法可以有效预测冠状动脉疾病发生。而ABI＜0．9则没有表现出统计学意义。