脉搏波传导速度和颈动脉粥样硬化对冠心病的诊断价值  

Diagnosis value of pulse wave velocity and carotid artery atherosclerosis for coronary heart disease

作　　者：边宁[1] 张涛[1] 李自成[1] 张爱东[1] 单光华[1] 

机构地区：[1]暨南大学附属第一医院心内科,广州510630

出　　处：《临床心血管病杂志》2012年第9期657-659,共3页Journal of Clinical Cardiology

基　　金：广东省科技计划项目(No:2010-1096-136);暨南大学第一临床医学院重点学科基金(No:2010-4)

摘　　要：目的:探讨臂踝脉搏波传导速度(baPWV)和颈动脉粥样硬化对冠心病(CHD)的诊断价值。方法:106例患者行baPWV检测和颈动脉彩色超声检测,再行经皮选择性冠状动脉(冠脉)造影。计算baPWV诊断CHD的截尾点、敏感度和特异度,以及baPWV超出年龄和性别预测值的百分数为22.5%时诊断CHD的截尾点及敏感度和特异度;分析颈动脉粥样硬化对CHD诊断的敏感度和特异度;联合二者分析平行试验时对CHD诊断的敏感度和特异度,并对不同CHD亚组进行组间分析。结果:运用ROC曲线求得曲线下面积为0.655,baP-WV超出年龄预测值百分数为22.5%时获得最大准确度,其对CHD诊断的敏感度为0.632,特异度为0.618;颈动脉粥样硬化对CHD诊断的敏感度为0.885,特异度为0.684;联合二者平行试验对CHD诊断的敏感度提高为0.958,特异度降低为0.432。结论:联合baPWV检测和颈动脉彩色超声检查可作为有创冠脉造影检查前的无创筛查手段。Objective：To explore the diagnosis value of brachial-ankle pulse wave velocity（baPWV） and carotid atherosclerosis for coronary artery disease（CHD）. Method：One hundred and six subjects were achieved the test of baPWV,color Doppler detection carotid artery and percutaneous selective coronary angiography.baPWV value for cut-off point,the sensitivity and specificity of CHD diagnosis was calculated.The percentage of baPWV beyond the predictive value of age and sex to diagnose of CHD cut-off point and the sensitivity and specificity was calculated.Carotid atherosclerosis value in diagnosis of sensitivity and specificity of CHD was analyzed.Both were combined to analyze the parallel tests for diagnosis of sensitivity and specificity of CHD.Then inter-group analysis between different sub-groups CHD was carried out. Result：The area under the ROC curve was 0.655.When the percentage of baPWV was more than the age predictive value 22.5%,the accuracy was max,and sensitivity for diagnosis of CHD was 0.632,while specificity was 0.618.The sensitivity of carotid atherosclerosis was 0.885 and specificity was 0.684.The sensitivity of parallel combined tests raised to 0.958 and specificity decreased to 0.432. Conclusion：The possibility of subjects suffering from CHD can be preliminarily assessed with combination of baPWV test and carotid color ultrasound examination,and it can be used as the non-invasive screening tool before the invasive coronary angiography.

关 键 词：冠心病 臂踝脉搏波传导速度 颈动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病]