踝臂脉搏波速对冠心病的预测及筛查价值

发布时间：2018-03-28 23:11

本文选题：冠心病　切入点：踝臂脉搏波速　出处：《临床心血管病杂志》2017年12期

【摘要】：目的:通过对踝臂脉搏波速(baPWV)的检测分析,探究baPWV对冠心病的预测及临床筛查的价值。方法:从1 460例接受选择性冠状动脉(冠脉)造影或冠脉CTA检查的患者中,筛选出冠心病患者483例(CHD组),冠脉粥样硬化患者677例(AS组),冠脉血管正常者300例(NL组)。各组之间的baPWV比较采用t检验,相关性分析用Pearson检验;绘制baPWV预测及筛查冠心病的ROC特征曲线。结果:CHD组与AS、NL组之间的年龄、体质指数(BMI)、腰围、收缩压、脉压、餐后2h血糖、低密度脂蛋白胆固醇、超敏C反应蛋白、血尿酸、血肌酐等各项指标差异存在统计学意义(均P0.05);CHD组与AS组、NL组之间的baPWV值差异存在统计学意义(P0.05)。相关性分析显示,baPWV水平与冠心病患者危险因素呈正相关;ROC曲线显示,以baPWV对冠心病的发生进行预测,1 545cm/s为截断点,其中曲线下面积为0.703,标准误0.015(P0.001);其灵敏度、特异度分别为89.8%和63.6%,阴性预测值(+PV)83.9%,阳性预测值(-PV)50.5%。结论:baPWV水平与冠心病患者的发病有着密切相关性,其对冠心病的预测和筛查具有重要的临床应用价值,有可能为冠心病患者未来的早期预防及治疗寻求新靶点提供更早、更可靠的科学依据。
[Abstract]:Objective: to explore the value of baPWV in predicting coronary heart disease (CHD) and clinical screening by analyzing the ankle brachial pulse wave velocities. Methods: a total of 1 460 patients underwent selective coronary angiography or coronary CTA examination. 483 patients with coronary heart disease (CHD), 677 patients with coronary atherosclerosis (as) and 300 patients with normal coronary artery (baPWV) were selected. T test and Pearson test were used to compare the baPWV among the three groups. Results the age, BMI, waist circumference, systolic blood pressure, pulse pressure, 2 h postprandial blood glucose, low density lipoprotein cholesterol, hypersensitive C-reactive protein and uric acid were measured. There were statistically significant differences in serum creatinine and other indexes (P 0.05) between CHD group and as group (P 0.05). Correlation analysis showed that there was a positive correlation between serum creatinine and risk factors in patients with coronary heart disease. Using baPWV to predict the occurrence of coronary heart disease (CHD), the truncation point was 1 545cm/s, in which the area under the curve was 0.703 and the standard error was 0.015g / P0.001.The sensitivity of the method was as follows:. The specificity was 89.8% and 63.6%, respectively. The negative predictive value was 83.9, and the positive predictive value was 50.5.Conclusion there is a close relationship between the level of% ba PWV and the incidence of coronary heart disease, which has important clinical application value in predicting and screening coronary heart disease. It may provide an earlier and more reliable scientific basis for the early prevention and treatment of coronary heart disease.
【作者单位】：武汉市第三医院心内科;华中科技大学同济医学院附属协和医院老年科;
【基金】：湖北省武汉市卫计委临床医学科研项目(WX10B04)
【分类号】：R541.4

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