肱-踝脉搏波传导速度及踝臂指数对冠状动脉病变程度的预测价值

Ankle brachial pulse wave transmission speed-and ankle arm index of coronary artery disease of predictive value

目的：评价肱-踝脉搏波传导速度（brachial-ankle pulsewave velelocity,BaPWV）及踝臂指数（anklebrachial pressure index,ABI）在冠心病高危人群对冠状动脉病变程度的预测价值。方法：对186例冠状动脉造影（CAG）患者行BaPWV及ABI测量、病史采集及常规化验检查,评价BaPWV及ABI对冠心病高危人群冠状动脉病变程度的预测价值。结果：186例患者分别依据冠状动脉病变程度分为4组。①冠脉造影阳性者的BaPWV较冠脉造影正常者显著增高（P＆lt;0.05）。BaPWV在单支病变组[（11.53±1.96）m/s]、双支病变组[（12.45±1.23）m/s]、严重病变组[（14.20±3.24）m/s]组间相比均差异有显著性（P＆lt;0.05）。②ABI仅在严重病变组与其他3组相比差异有显著性。结论：BaPWV及ABI均可反映冠脉病变的程度;BaPWV升高是预测冠状动脉病变程度的早期指标,且与冠状动脉病变严重程度呈正相关;ABI降低是反映冠状动脉病变较晚期的指标,对冠脉严重病变预测价值较大。

Objective：Evaluate the value of brachial-ankle pulsewave velelocity （BaPWV） and anklebrachial pressure index （ABI） in predicting the extent of coronary artery lesions at CHD high-risk groups.Methods：We studied 186 consecutive patients who had taken coronary angiography or percutaneous coronary intervention. All patients underwent ABI,BaPWV and serum factors evaluation in addition to history collection. The applicability of ABI and BaPWV as the markers for predicting the prevalence of CHD in subjects at high risk of atherosclerotic cardiovascular disease was compared. Results： We divided the 186 patients into 4 groups according to their extent of coronary artery lesions. BaPWV was significantly higher in the pa- tients who got positive results when CAG than that in those got negative results （ P 〈 0. 05）. Among patients of 1 - vessel disease[ （ 11.53± 1.96） m/ s], 2- vessel disease[ （12.45 ± 1.23） m/s] and 3 - vessel disease[（14.20 ± 3.24） m/s], there are significant differences in BaPWV（ P 〈 0.05） . Only compare 3 - vessel disease group with other 3 groups, there are significant differences in ABI. Conclusion： Both BaPWV and ABI can reflect the extent of coronary atherosclerosis lesions. A high BaPWV is an early period relevant index in predicting the extent of coronary artery lesions, and it is a positive relationship with the extent of coronary artery lesions. A low ABI is a relatively late period index, having much more value in predicting severe coronary artery lesions.