FA-IMT与ABI评价冠心病患者冠脉狭窄程度及相关性研究

发布时间：2018-06-23 23:11

本文选题：冠心病 + 股动脉内中膜厚度　；参考：《石河子大学》2015年硕士论文

【摘要】：目的:1、通过检测股动脉内中膜厚度(FA-IMT)及踝臂指数(ABI),评价二者和冠心病的相关水平,分析其对冠心病患者冠状动脉狭窄程度的预测价值。2、讨论冠心病的相关危险因素。方法:收集2013年12月至2014年7月在石河子大学医学院第一附属医院行冠状动脉造影患者98例,根据造影结果分为:一支病变组31例,男:22例,女:9例,平均年龄(58±8)岁;两支病变组27例,男:18例,女:9例,平均年龄(58±10)岁;三支病变组16例,男:11例,女:5例,平均年龄(62±9)岁;健康对照组24例,男:13例,女:11例,平均年龄(57±6)岁。经患者知情同意后纳入研究,对入选者均进行术前股动脉血管超声及ABI测量、病史采集及常规化验检查。分析对照组与不同程度冠脉病变组FA-IMT与ABI差异是否具有统计学意义,并分析FA-IMT、ABI与冠心病的相关性,评价其对冠心病患者冠状动脉狭窄程度的预测价值,讨论冠心病的相关危险因素。结果:1、性别、年龄、脑卒中病史在各组间比较P均0.05,无统计学意义;体重指数、高血压病史、吸烟史在各组间比较,P均0.05,存在差异,有统计学意义。2、HDL、TC、LP(a)组间比较均无显著差异,无统计学意义(P均0.05);LDL、TG、Hcy各组间比较,P均0.05,存在差异,有统计学意义。3、FA-IMT在不同病变组间比较,存在显著差异,有统计学意义(x2=41.35,P0.01),病例组的FA-IMT[单支病变组(0.17±0.07)cm),双支病变组(0.24±0.07)cm,三支病变组(0.34±0.06)cm]分别明显高于对照组[(0.15±0.10)cm],P均0.01;ABI在不同病变组间比较,存在显著差异,有统计学意义(x2=21.90,P0.01)。病例组的ABI[单支病变组(0.98±0.18),双支病变组(0.86±0.14),三支病变组(0.86±0.13)]分别明显低于对照组[(1.06±0.17)],P均0.01。4、相关结果分析:FA-IMT对冠状动脉粥样硬化的预测:灵敏度为75.7%,特异度为50%,阳性预测值为82.4%,阴性预测值为40%,阳性似然比为1.51,阴性似然比为0.49;ABI对冠状动脉粥样硬化的预测:灵敏度为68.9%,特异度为70.8%,阳性预测值为87.9%,阴性预测值为42.5%,阳性似然比为2.36,阴性似然比为0.44。FA-IMT联合ABI能较好的预测冠状动脉粥样硬化程度,有一定的预测价值。5、spearman等级相关分析表明,FA-IMT与冠状动脉粥样硬化呈正相关关系,相关系数R=0.649;ABI与冠状动脉粥样硬化呈负相关关系,相关系数R=-0.459;FA-IMT与ABI存在负相关关系,相关系数R=-0.606。结论:1、体重指数、高血压病史、吸烟史、低密度脂蛋白(LDL)升高、甘油三酯(TG)升高、高同型半胱氨酸(HCy)是造成冠状动脉粥样硬化的危险因素;2、FA-IMT与ABI可以预测冠心病患者冠状动脉狭窄程度。3、FA-IMT越厚,提示冠心病冠脉狭窄程度可能越严重,ABI越低,提示冠心病冠脉狭窄程度可能越严重,二者联合诊断冠心病效果更佳。
[Abstract]:Objective to evaluate the correlation between internal medial thickness (FA-IMT) and ankle brachial index (ABI) of femoral artery, analyze their predictive value of coronary artery stenosis in patients with coronary artery disease (CHD), and discuss the risk factors of coronary artery disease (CHD) by measuring the medial thickness of femoral artery (FA-IMT) and ankle brachial index (ABI). Methods: from December 2013 to July 2014, 98 patients underwent coronary angiography in the first affiliated Hospital of Shihezi University Medical College. According to the results of coronary angiography, they were divided into one branch group (31 cases), 22 males and 9 females, with an average age of (58 卤8) years. The mean age was (58 卤10) years in the two-vessel disease group (n = 18) and in the female group (n = 9), the mean age was (57 卤6) years in the three-vessel disease group (n = 16, male: 11, female: 5, mean age: 62 卤9), and healthy control group (n = 24, male: 13, female: 11, mean age: 57 卤6). After informed consent, the patients were examined with ultrasound and ABI of femoral artery before operation, history collection and routine laboratory examination. To evaluate the predictive value of FA-IMT and ABI in patients with coronary artery disease (CHD), the difference between FA-IMT and ABI was statistically significant, and the correlation between FA-IMT ABI and coronary artery disease (CHD) was also analyzed in order to evaluate the predictive value of FA-IMT and ABI in patients with coronary artery disease. To discuss the related risk factors of coronary heart disease. Results there was no significant difference in body mass index (BMI), hypertension history and smoking history between the two groups (P 0.05, P < 0.05), but there was no significant difference between the two groups (P > 0.05), and there was no significant difference between the two groups in the TCLP (a) group (P > 0.05), and there was no significant difference in body mass index (BMI), hypertension history and smoking history (P < 0.05) between the two groups, and there was no significant difference between the two groups. There was no significant difference (P 0.05) between the two groups (P 0.05), and there was significant difference between the three groups, and there was significant difference between the three groups, and there was significant difference among the different pathological groups (P < 0.05), and there was significant difference between the three groups (P < 0.05). There was significant difference in FA-IMT [(0.17 卤0.07) cm in the single vessel lesion group and (0.34 卤0.06) cm in the three vessel lesion group] compared with the control group [(0.15 卤0.10) cm] (P < 0.01). There was significant difference between the two groups (x221.90P0.01). ABI [single vessel lesion group (0.98 卤0.18), double vessel lesion group (0.86 卤0.14), three-vessel lesion group (0.86 卤0.13)] was significantly lower than that of control group [(1.06 卤0.17)] P < 0.01.4. The results of correlation analysis showed that the sensitivity, specificity and positive predictive value of 20% FA-IMT in predicting coronary atherosclerosis were 75.7, 50 and 50, respectively. For coronary artery atherosclerosis, the sensitivity is 68.9, the specificity is 70.8, the positive predictive value is 87.9, the negative predictive value is 42.5, the positive likelihood ratio is 2.36, the negative likelihood ratio is 2.36, and the negative likelihood ratio is 0.49. The predictive value is 82.4, the negative predictive value is 40, the positive likelihood ratio is 1.51, the negative likelihood ratio is 0.49, the specificity is 70.8, the positive predictive value is 87.9, the negative predictive value is 42.5, the positive likelihood ratio is 2.36, and the negative likelihood ratio is 2.36. A ratio of 0.44.FA-IMT combined with ABI could better predict the degree of coronary atherosclerosis. The correlation analysis showed that FA-IMT had a positive correlation with coronary atherosclerosis, and the correlation coefficient RG0.649 ABI had a negative correlation with coronary atherosclerosis, and the correlation coefficient R ~ (-0.459) ~ (FA-IMT) was negatively correlated with ABI, and the correlation coefficient was R ~ (-0.606). Conclusions: 1, BMI, hypertension history, smoking history, low density lipoprotein (LDL), triglyceride (TG) were increased. High homocysteine (HCy) is the risk factor of coronary atherosclerosis. 2FA-IMT and ABI can predict the degree of coronary artery stenosis. It is suggested that the severity of coronary artery stenosis may be more serious, and the combined diagnosis of coronary artery disease is more effective.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.4

【相似文献】