踝臂指数与冠心病的相关性研究

Relevant research of ankle-brachial index and the coronary artery disease

目的：观察踝臂指数对冠心病及其严重程度的预测价值。方法收集478例行冠状动脉造影者的临床资料，测定生化指标及踝臂指数（ABI）。结果冠心病组和非冠心病组的ABI差异有高度统计学意义（P〈0.01）。ABI〈0.9和ABI〉1.3组的冠心病患者比率明显高于ABI正常组（P〈0.05）。 Logistic回归分析显示：ABI值异常（〈0.9或〉1.3）是冠心病的独立影响因素。ABI异常（〈0.9或～1.3）预测冠心病的灵敏度为16.4%，特异度为94.6%。ABI在非冠心病、单支病变、双支病变、三支病变组之间差异有高度统计学意义（P〈0.01），ABI随病变支数增加而逐渐降低。ABI值分别在〈0.9、0.9～1.3、〉1.3时，三组间冠脉单支病变、双支病变、三支病变所占比率差异有统计学意义（P〈0.05），两两比较结果显示：ABI〈0.9组单支病变比率明显小于ABI正常组；ABI〉1.3组双支病变比率明显大于ABI正常组；ABI〈0.9组三支病变比率明显大于ABI正常组。结论 ABI对于冠心病及其严重程度具有预测价值，且优于传统危险因素。 ABI预测冠心病敏感度低，特异度高。

Objective To observe the prediction value of ankle-brachial index （ABI） to the coronary artery disease （CAD） and its severity. Methods The clinical data of 478 patients with coronary angiogram were selected in the study. The biochemical indexes and ABI was detected. Results ABI was significantly lower in the CAD group than those in the CAD group （P〈0.01）. The CAD rates of the ABI〈0.9 group and ABI〉1.3 group were both significantly higher than that of ABI normal group （P〈 0.05）. Abnormal ABI values （〈0.9 or 〉1.3） were independent factors of CAD according to the logistic regression. Abnormal ABI （〈0.9 or〉 1.3） could predict the presence of CAD with a sensitivity of 16.4%and specifity of 94.6%. The ABI values were significant different among the non CAD group, the 1-vessel CAD group, the 2-vessel CAD group and the 3-vessel CAD group （P〈 0.01）. The rates of the 1-vessel CAD, the 2-vessel CAD and the 3-vessel CAD were all significantly different among the ABI〈0.9 group, ABI 0.9-1.3 group and ABI〉1.3 group （P〈 0.05）. The rate of the 1-vessel CAD of the ABI 〈 0.9 group was significantly lower than that of the ABI normal group. The rate of the 2-vessel CAD of the ABI〉1.3 group was significantly higher than that of the ABI normal group. The rate of the 3-vessel CAD of the ABI〈0.9 group was significantly higher than that of the ABI normal group. Con-clusion ABI has prediction value to the CAD and its severity, which is better than the traditional risk factors. ABI can predict CAD with low sensitivity and high specifity.