踝臂指数对早发冠心病三支病变的预测价值

Usefulness of ankle brachial index to predict three-vessel coronary artery lesions of premature coronary heart disease

目的评价踝臂指数(ABI)对早发冠心病冠状动脉三支病变的预测价值。方法选取我院心脏科住院的早发冠心病患者194例,入院患者均已行ABI及冠状动脉造影检查。根据冠状动脉造影结果分为单支病变组(57例)、双支病变组(55例)、三支病变组(82例),并将单支病变组与双支病变组合并为非严重病变组。比较非严重病变组与三支病变组ABI异常率,并以多元logistic回归方法分析早发冠心病冠状动脉三支病变的独立危险因素。结果三支病变组ABI异常率明显高于非严重病变组,19.5%(16/82)vs 2.7%(3/112),差异有统计学意义(P<0.01);多元logistic回归分析提示,ABI≤0.9是早发冠心病冠状动脉三支病变的独立危险因素(OR=5.529,95%CI=1.333～22.930)。结论 ABI≤0.9对早发冠心病冠状动脉三支病变有一定的预测价值。

Objective To evaluate the usefulness of ankle brachial index （ABI） to predict three-vessel coronary artery lesions in premature coronary heart disease. Methods The study enrolled 194 patients in cohort who were hospitalized in the hospital and were diagnosed as premature coronary heart disease. The patients had both ABI data available and coronary angiography（CAG） ,and they were divided into three groups based on CAG results, single-vessel group（57 cases）, double-vessel group （ 55 cases） and three-vessel group （ 82 cases）. In addition, single-vessel group and double-vessel group were merged into non-severe group. The ratio of abnormal ABI was compared between non-severe group and three-vessel group and multivariate logistic regression analysis was performed to evaluate the risk factors of premature ~hree-vessel coronary artery lesions. Results The ratio of abnormal ABI in three-vessel group was more than non-severe group,there was significant difference between two groups,19.5%（16/28） vs 2.7%（3/112）（ P 〈0.01）. After multivariate logistic regression analysis, ABI≤0.9 was the independent risk factor in the occurrence of premature three-vessel coronary artery lesions （ OR = 5. 529,95% CI=1. 333-22. 930）. Conclusion ABI≤0.9 can predict the occurrence of premature three-vessel coronary artery lesions.