基于血管内超声评价冠状动脉临界病变的相关危险因素分析

Analysis of risk factors of coronary artery intermediate lesions on intravascular ultrasound

目的通过研究前降支近段或中段临界病变接受血管内超声（intravasc ularultrasound，IVUS）检查患者的临床特征，分析影响最小管腔面积（minimal lumenarea，MLA）的危险因素。方法选择符合入选标准的90例患者，收集其人口学资料、病史以及实验室检查数据，进行线性回归分析，筛选出影响MLA的危险因素。进一步以MLA〈4．0mm。或≥4．0mm。为界限进行区分，采用ROC曲线测定Logistic回归寻找到的危险因素在评价MLA中的价值。结果前降支近段或中段临界病变患者中，年龄、病变血管支数为独立危险因素。ROC曲线下面积AUC=0．686，P=0．004，95％置信区间（C／）为0．574～0．798。结论前降支近段或中段临界病变中，年龄、病变血管支数为预测MLA的独立危险因素。

Objective To study the clinical characteristics of the proximal or middle left anterior descending artery intermediate lesions with IVUS examination and further analyze the risk factors affecting the lumen area. Methods 90 patients who met the inclusion criteria were enrolled and their demographic information, medical history and laboratory data were collected for analysis. Simple linear regression analysis was performed to study the risk factor of minimum lumen area （MLA） . Further study with MLA 〈 4.0 mm^2 or ≥4. 0 mm^2 as cutting value was done for determination of risk factors by means of ROC regression method. Results In patients with proximal or middle left anterior descending artery intermediate lesions, age and number of stenotic ressels are the possible risk factors （ both P 〈 0. 05 ） . Taking MLA 〈 4. 0 mm^2 or 〉14. 0 mm^2 as cutting point for assessment of diagnotie value of MLA, the area under ROC curve （AUC） = O. 686, P = O. 004 and 95% CI is （0. 574, 0. 798） . Conclusions Age, number of vessels disease are possible risk factors in predicting the minimum lumen area in the proximal or middle left anterior descending artery intermediate lesions.