心踝指数评价冠状动脉狭窄严重程度的价值研究

Value of Cardio-ankle Vascular Index in Evaluating the Severity of Coronary Artery Stenosis

背景心踝指数(CAVI)与动脉粥样硬化有良好的相关性,其不受血压影响,可较好预测动脉血管功能改变。目的通过探讨CAVI与冠状动脉Gensini积分相关性来预测冠状动脉的严重程度,分析CAVI与冠心病危险因素的关系。方法选取2015年9月—2016年1月于郑州大学第一附属医院心血管内科治疗的冠心病患者300例为研究对象。根据四分位数法将患者分为四组,A组(积分<1分)78例,B组(1分≤积分<12分)115例,C组(12分名积分<38分)59例,D组(积分≥38分)48例。采用彩色多普勒法测量患者心踝脉搏传导时间、收缩压、舒张压,计算CAVI。结果年龄、吸烟史、高血压史、血脂异常、糖尿病史是CAVI的独立影响因素(P<0.05)。校正混杂因素后,Gensini积分与CAVI呈正相关(P<0.05)。结论通过血管功能性指标CAVI可预测冠状动脉血管的结构性改变。

Background There is a certain correlation between cardio - ankle vascular index （ CAVI ） and atherosclerosis, and CAVI can predict the function of arterial and is independent of blood pressure. Objective To explore the correlation of CAVI and coronary heart Gensini score, and to predict the severity of coronary artery and analyzes the relations between CAVI and risk factors for coronary heart disease. Methods 300 cases of coronary heart disease patients selected from the First Affiliated Hospital of Zhengzhou University from September 2015 to January 2016. The subjects were divided into four groups according to the Gensini score quartile method, Group A （Gensini score 〈 1, 78 cases） , Group B （1 ≤ Gensini score 〈 12,115 cases）,Group C （ 12 ≤ Gensini score 〈 38,59 cases ）,and Group D （ Gensini score ≥ 38,48 cases ） . Measurement of pulse duration, systolic blood pressure and diastolic blood pressure of the patients were conducted by color Doppler method, and the CAVI were calculated. Result Age , smoking history , history of hypertension, dyslipidemia , diabetes history were the independent influencing factors of CAVI （ P 〈 0. 05 ） . After adjusting for confounding factors, the Gensini score was positively correlated with CAVI （P 〈 0. 05 ）. Conclusion The structural changes of the coronary vessels can be predicted by the CAVI.