大动脉僵硬度与冠脉病变严重性的相关研究

The value of large artery stiffness in risk stratification outcomes evaluation in patients who received percutaneous coronary intervention

目的:探讨大动脉僵硬度与冠脉病变严重程度的相关性。方法:选择2006年1月—2007年12月疑诊为冠心病入院患者637例,所有入选患者均进行颈股脉搏波传导速度(C-FPWV)检测,评价动脉僵硬度。行冠脉造影评价冠脉病变严重程度。根据C-FPWV水平分为三组:组(C-FPWV0～10.0,220例),组(C-FPWV10.1～13.0,242例),组(C-FPWV≥13.1,175例),观察患者临床特征。结果:各组间比较,组年龄偏大,糖尿病,心肌梗死和高血压病史多,C型病变和三支病变常见,多因素Logistic分析冠脉病变严重程度和C-FPWV呈正相关联,相对危险性(OR)为1.51(95%CI 1.017～2.241)。结论:C-FPWV是最为经典的评价动脉僵硬度的方法,与冠脉病变的严重程度密切相关,可作为心血管疾病的一个危险信号,指导早期干预,为心血管疾病独立强有力预测因子,对冠心病防治有广泛应用前景。

Objective：To evaluate the relationship between large artery stiffness and the severity degree of coronary atherosclerosis in patients who received coronary arteriography. Methods：We studied 637 consecutive patients who received coronary arteriography carotid-femoral puise wave velocity（C-FPWV） to evaluate large artery stiffness were measured. The severity degree of coronary atherosclerosis was shown as the score of coronary artery. According to C-FPWV they were divided into the following groups： I group（C-PPWV 0~10.0,220 patients）, Ⅱ group（C-FPWV 10.1 ~ 13.0,242 patients）, Ⅲ group （C-FPWV≥ 13. 1,175 patients）. The clinical characteristics were analyzed. Results：The percentage of older patients ,diabetes,hypertension,myocardial infarction,type C lesion,three artery and the score of coronary artery were higher in Ⅲ group compared other groups（P〈0.05）. Multi-logistic analysis showed that C - FPWV was positively related to the severity of coronary artery stenosis . OR was 1. 51 （95 %CI1. 017 2. 241）. Conclusion：C-FPWV was the most classical method reflecting large artery stiffness and closely related to the severity of coronary artery stenosis. It could be a strong and independent factor of risk stratification outcomes evaluation and prognosis in patients who received coronary vascular disease. It should be applied widely to prevention and cure of coronary vascular disease.