老年冠心病患者踝臂指数与冠状动脉病变SYNTAX积分相关性研究

Relationship between ankle brachial index and coronary SYNTAX score in elderly patients with coronary heart disease

目的 探讨踝臂指数与冠状动脉病变严重程度的关系,并评价其预测价值.方法 纳入2012年1月至2014年12月在南京医科大学第一附属医院心血管科及老年心血管科行冠状动脉造影,同时接受踝臂指数（ABI）和趾臂指数（TBI）检查的192例老年患者,根据冠状动脉造影结果及SYNTAX积分分为非冠心病组,冠心病低危组、中危组及高危组.分析非冠心病组与冠心病组、冠心病不同亚组间ABI、TBI水平的差异,利用Pearson相关性分析踝臂指数与SYNTAX积分的相关性,并利用ROC曲线分析ABI对预测冠心病的价值.结果 与非冠心病组比较,冠心病组ABI、TBI显著降低（ABI：1.032±0.189比0.954±0.181;TBI：0.775±0.143比0.740±0.176）,差异有统计学意义（P＜0.05）.冠心病组中低危组、中危组及高危组组ABI、TBI呈降低趋势（ABI：1.004±0.170比0.958±0.184比0.875±0.167;TBI：0.768±0.108比0.753±0.124比0.679±0.179）,组间ABI、TBI比较,差异具有统计学意义（P＜0.05）.高危组ABI、TBI水平明显低于非冠心病组、低危组及中危组,差异具有统计学意义（P＜0.05）;中危组与非冠心病组ABI水平比较,差异有统计学意义（P＜0.05）.Person相关分析显示,ABI与SYNTAX积分呈轻度负相关（rho=-0.443,P＜0.01）.结论 ABI值能较好反映冠脉病变严重程度,ABI数值越低,冠状动脉病变SYNTAX积分越高.

Objective To explore the correlation of ankle brachial index （ABI） and coronary SYNTAX score in elderly patients with coronary heart disease, and evaluate the predictive value. Methods A total of 192 patients were enrolled from the department of Geriatrics and Cardiovascular in the first affiliated hospital of Nanjing Medical University. They had both coronary angiography, ABI and TBI data available. Patients were divided into four groups based on CAG results and SYNTAX score： non-CHD group, low-risk group, mid-risk group and high-risk group. The differences of ankle-brachial between non-CHD group and coronary disease group, low- risk group, mid-risk group and high-risk group were analyzed. The relationship between ankle brachial index and SYNTAX score were analyzed using bivariate analysis. Results The ankle brachial index and toe brachial index of coronary disease group were apparently lower than non-CHD group （ABI：1.032±0.189 vs. 0.954±0.181,TBI： 0.775±0.143 vs. 0.740±0.176）, the difference had statistical significance （P〈0.05）. ABI and TBI had a descent trend in low-risk group, mid-risk group and high-risk group （ABI： 1.004±0.170 vs. 0.958±0.184 vs. 0.875±0.167, TBI：0.768±0.108 vs. 0.753±0.124 vs. 0.679±0.179）, and comparison in ABI, TBI showed statistical dif- ference （P〈0.05）. ABI and TBI in high-risk group were obviously lower than low-risk group, mid-risk group and control group, the difference had statistical significance （P〈0.05）. ABI in mid-group was lower than control group, the difference had statistical significance （P〈0.05）. Pearson correlation analysis indicated that ABI was mild negatively correlated with coronary SYNTAX score （rho =-0.443, P〈0.01 ）. Conclusion ABI can reflect well the severity of coronary artery lesion, the lower ABI value, the hi^her coronary SYNTAX score is observed.