脉搏波传导速度对冠心病诊断及冠状动脉狭窄程度的预测价值  

Predictive value of pulse wave velocity in diagnosis of coronary heart disease and severity of coronary stenosis

作　　者：庞兴学[1,2] 王显[3] 赵怀兵[3] 任晓霞[1,2] 吕明芳[2] 胡大一[4] 

机构地区：[1]北京军区总医院心内科,北京100070 [2]山西医科大学第二临床医学院 [3]北京中医药大学附属东直门医院心内科 [4]北京大学人民医院心内科

出　　处：《中国循证心血管医学杂志》2011年第2期101-104,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：国家自然科学基金资助项目(30671795)

摘　　要：目的评价臂踝脉搏波传导速度(baPWV)在冠心病诊断中的预测价值及臂踝脉搏波传导速度改变(baPWV)与冠状动脉狭窄程度(SYNTAX积分)的相关性。方法选择行冠状动脉造影患者452例,根据冠状动脉造影结果,将入选患者分为冠心病组(251例)和非冠心病组(201例),冠心病组再按冠状动脉狭窄程度(SYNTAX分级),分为轻、中、重三个亚组,所有患者在冠状动脉造影前应用脉搏波速度测量baPWV、baP-WV;依据冠状动脉造影结果诊断冠心病,应用ROC曲线评价baPWV对冠心病预测价值,并对冠心病组的baPWV及SYNTAX积分进行相关分析。结果 baPWV及baPWV在冠心病组和非冠心病组之间差异有统计学意义(P<0.01);在冠心病病变亚组,baPWV在轻、中、重三个亚组之间差异具有统计学意义(P<0.001);baPWV对SYNTAX积分的ROC曲线,在截断点22.5时,曲线下面积最大,预测冠心病的特异性是75.2,敏感性是60.6;baPWV与SYNTAX积分呈中度正相关(rho=0.545,P<0.01)。结论 baPWV、baPWV对冠心病诊断有中等预测价值,但其特异性和敏感性受限。Objective To review the predictive values of brachial-ankle pulse wave velocity（baPWV） in the diagnosis of coronary heart disease（CHD） and correlation between the changes of baPWV（baPWV%） and severity of coronary stenosis（SYNTAX integral）.Methods The patients having coronary angiography（CAG,n=452） were divided into the CHD group（n=251） and non-CHD group（n=201） according to the outcomes of CAG.The CHD group was divided again into three sub-groups：mild group,moderate group and severe group according to the severity of coronary stenosis（SYNTAX grading）.The changes of baPWV and baPWV% were detected by using the measure system of PWV in all patients before CAG.CHD was diagnosed based on the outcomes of CAG.The predictive value of baPWV% was reviewed by using receive operating characteristic curve（ROC） and the correlation between baPWV% and SYNTAX integral was analyzed in the CHD group.Results The differences of baPWV and baPWV% were statistically significant between the CHD group and non-CHD group（P0.01）.In three sub-groups,the difference of baPWV% was statistically significant among mild group,moderate group and severe group（P0.01）.The cutpoint was 22.5% in ROC of baPWV% to SYNTAX and the area under the curve was the largest.The specificity for predicting CHD was 75.2% and sensitivity was 60.6%.There was a moderate and positive correlation between baPWV% and SYNTAX integral（rho=0.545,P0.001）.Conclusion The predictive values of baPWV and baPWV% are moderate in the diagnosis of CHD and the specificity and sensitivity are limited.

关 键 词：冠心病 脉搏波传导速度 特异性 敏感性 

分 类 号：R541.4[医药卫生—心血管疾病]