踝臂指数在老年冠心病合并下肢外周动脉病患者诊断中的应用价值  

The Diagnostic Value of Ankle Brachial Index in Elder Coronary Heart Disease Patients with Lower Extremity Peripheral Artery Disease

作　　者：鄂立平[1] 李海燕[1] 

机构地区：[1]北京市和平里医院心内科,100013

出　　处：《中国全科医学》2011年第26期2969-2972,共4页Chinese General Practice

基　　金：首都医学发展科研基金管理委员会项目(2007-3168)

摘　　要：目的探讨踝臂指数(ABI)在老年冠心病合并下肢外周动脉病诊断中的应用价值。方法通过对557例老年冠心病患者进行ABI及下肢动脉血管超声检查,以下肢动脉血管超声检查为金标准,观察二者的相关性,同时对其敏感性及特异性进行评估。并将冠心病患者分为稳定性冠心病(SAP)和急性冠脉综合征(ACS,包括不稳定型心绞痛和急性心肌梗死)两组,观察ABI的差异性,同时多变量分析ABI与冠心病严重程度的相关性。结果以下肢动脉血管超声检查为金标准,ABI检查的敏感性为73.21%,特异性为90.39%。下肢动脉狭窄程度与ABI呈负相关(r=-0.511,P<0.01)。冠心病两组ABI差异有统计学意义(P<0.001),ABI与冠心病的严重程度呈正相关(r=0.751,P<0.01);Logisitic回归分析结果显示:年龄、心血管病家族史、高血压、糖尿病、血纤维蛋白原、三酰甘油及ABI与冠心病的严重程度有关(P<0.05)。结论 ABI检查与下肢血管超声检查相关性好,同时其与冠心病的严重程度有关,有助于预测冠心病的严重程度,且其操作简便,无创伤性,临床上尤其适宜在基层医院推广应用。Objective To explore the diagnostic value of ankle brachial index （ABI） in elder coronary heart disease patients with peripheral arterial diseases. Methods ABI and lower limbs arterial ultrasound （ considered as the golden index） were determined in 557 aged patients with coronary heart disease, with the results of the two diagnostic approached compared in terms of sensitivity and specificity. ABI was compared between the stable angina pectoris （SAP） group and the acute coronarysyndrome （ACS） and ABI associations with the severity of the coronary heart disease were analyzed through multivariate analysis. Results Lower limb artery blood vessels ultrasound examination was considered as the golden standard. ABI examination showed a specificity of 73.21% and a sensitivity of 90. 39%. A significant negative correlation was seen between specificity and sensitivi- ty （ r = - 0. 511, P 〈 0. 01 ）. ABI difference between the two groups of coronary heart disease was statistically significant （ P 〈0. 001 ）. ABI was positively correlated to CHD severity （r = 0.75 1, P 〈 0. 01 ）. Logisitic regression analysis showed that factors including age, family history of cardiovascular, high blood pressure, diabetes, fibrinogen （FIB）, triglyceride （TG）, and ABI were correlated with the severity of coronary heart disease （P 〈 0. 05）. Conclusion Results from ABI examination are cor- related with those from lower limb blood vessels ultrasound examinations, and also, the severity of coronary heart disease. ABI examination helps to predict the severity of coronary heart disease, and is worth popularization among grass - roots hospitals for its simplicity as a non -invasive technology.

关 键 词：冠心病 老年人 踝臂指数 动脉 

分 类 号：R541.4[医药卫生—心血管疾病]