肱踝脉搏波传导速度与冠状动脉造影Gensini积分相关性研究

The Correlation between brachial-ankle pulse wave velocity (BaPWV) and CAD severity assessed by angiography and the Gensini score

【目的】为探讨肱踝脉搏波传导速度(brachial-ankle pulse wave velocity,BaPWV)与冠状动脉造影Gensini积分相关性。【方法】选择某院2011年10月-2012年7月期间行冠状动脉造影检查的患者327例,根据冠状动脉造影(coronary angiography,CAG)结果,将入选患者冠心病组(256例)和非冠心病组(71例)。依据Gensini积分,所有患者又分为正常组、轻度病变组、中度病变组、重度病变组4个亚组。所有患者在冠状动脉造影前行血液生化检查及脉搏波速度测量。【结果】年龄、男性、吸烟、高血压、糖尿病、收缩压、脉压、总胆固醇、低密度脂蛋白是显著影响冠脉病变的危险因素(P<0.05);BaPWV在冠心病组与非冠心病组之间差异具有统计学意义(1 726±299 cm/s vs 1 500±232 cm/s,P<0.001)。BaPWV在轻度病变组(1 651±254 cm/s),中度病变组(1 712±302 cm/s),重度病变组(1 816±319 cm/s)与正常组(1 500±244 cm/s)比较差异有统计学意义(P<0.01),在重度病变组与中度病变组,轻度病变组间比较亦有统计学意义(P<0.05)。BaPWV与冠状动脉造影Gensini积分呈中度正相关(r=0.362,P<0.01)。以冠状动脉造影结果为金标准绘制ROC曲线,BaPWV对冠心病具有中等预测价值,其截断点1 535cm/s,敏感性为72.3%,特异性为69.8%。【结论】BaPWV随冠状动脉病变严重程度逐渐增大,它可以作为预测冠心病的一项指标。

【Objective】To explore the association between brachial-ankle pulse wave velocity（BaPWV） and CAD severity assessed by angiography and the Gensini score.【Methods】A total of 327 patient underwent coronary angiography from October 2011 to July2012.The patients were divided into CHD group（n = 256） and non-CHD group（n =71） according to the outcomes of CAG.Patients were divided again into four sub-groups according to Gensini score： normal group,mild group.moderate group and severe group.Blood biochemistry and brachial-ankle pulse wave velocity examined before coronary angiography.【Results】Age,male,smoking,history of hypertension,systolic blood pressure,pulse pressure,total cholesterol and low-density lipoprotein were significant risk factor of coronary atherosclerosis（P 0.05）.The difference of BaPWV between coronary group and control group was significant（1 726±299 cm/s vs 1 500±232 cm/s,P 0.001）.The difference of BaPWVbetween mild group（1 651±254 cm/s）.moderate group（1 712±302 cm/s）,severe group（1 816±319 cm/s） and normal group（1 500±244 cm/s）was significant（P 0.01）.The difference of BaPWVbetween severe group and mild group,moderate groupwas significant（P 0.05）.There was a moderate and positive correlation between brachial-ankle pulse wave velocity and CAD severity as assessed by Gensini score（r = 0.362,P 0.01）.With the outcomes of CAG as the gold standard for drawing ROC curve,BaPWV had an moderate predictive value for CHD with the cut-off point of 1 535cm/s,the sensitivity was72.3%,the specificity was 69.8%.【Conclusion】BaPWV increases with the severity and complexity of coronary atherosclerosis,which can be used as a predictive maker for CAD.