踝臂指数、趾臂指数、LDL-C/HDL-C在冠状动脉疾病中的应用价值  

Application values of ankle-brachial index,toe-brachial index and LDL-C/HDL-C to coronary artery disease

作　　者：耿松[1] 孙宇娇[1] 张鹏祥[1] 刘杰武[1] 齐国先[1] 

机构地区：[1]中国医科大学附属第一医院心内科,沈阳110001

出　　处：《中国循证心血管医学杂志》2014年第2期204-207,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨踝臂指数(ABI)、趾臂指数(TBI)、低密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值(LDL-C/HDL-C)在冠状动脉疾病患者中的应用价值。方法纳入2011年10月-2013年2月于中国医科大学附属第一医院心内科住院治疗的160例患者,依据冠状动脉多层螺旋CT造影(CTA)检查结果将患者分为两组,其中对照组患者57例(冠状动脉狭窄程度≤25%),冠状动脉病变组患者103例(冠状动脉狭窄程度>25%)。冠状动脉病变组患者中冠状动脉单支病变患者30例(单支病变组)、双支病变患者31例(双支病变组)、三支病变患者42例(三支病变组);轻度病变组患者55例(冠状动脉狭窄程度≤50%)及中重度病变组患者48例(冠状动脉狭窄程度>50%)。对入组患者行ABI、TBI、LDL-C/HDL-C检查,分析冠状动脉病变不同亚组间ABI、TBI、LDL-C/HDL-C水平变化及其对判断冠状动脉病变程度的价值。结果对照组与冠状动脉单支病变组、双支病变组、三支病变组间ABI、TBI呈降低趋势,LDL-C/HDL-C水平呈升高趋势,组间ABI、TBI、LDL-C/HDL-C水平比较,差异均有统计学意义(P<0.05);三支病变组与对照组、单支病变组ABI、TBI及LDL-C/HDL-C水平间比较,差异均有统计学意义(P<0.05);双支病变组与对照组ABI水平间比较,差异有统计学意义(P<0.05)。对照组与冠状动脉狭窄轻度病变组、中重度病变组间ABI、TBI呈降低趋势,LDL-C/HDL-C水平呈升高趋势,组间ABI、TBI、LDL-C/HDL-C水平比较,差异均有统计学意义(P<0.05);中重度病变组与对照组ABI、TBI及LDL-C/HDL-C水平间比较,差异有统计学意义(P<0.05);中重度病变组与轻度病变组及轻度病变组与对照组ABI水平间比较,差异有统计学意义(P<0.05)。结论 ABI能较好反应冠脉病变程度,ABI值越低冠脉狭窄越重,但并不能全面反映冠脉病变范围;LDL-C/HDL-C、TBI对冠脉病变的判断有一定意义,但不适用于准确评价冠脉病变程度及范围。Objective To investigate the application values of ankle-brachial index （ABI）, toe-brachial index （TBI） and ratio of LDL-C to HDL-C （LDL-C/HDL-C） in patients with coronary artery disease. Methods The patients （n=160） were chosen from the Department of Cardiovascular Diseases of the First Affiliated Hospital of China Medical University from Oct. 2011 to Feb. 2013, and divided into control group （n=57, severity of CAS≤25%） and CAS group （n=103, severity of CAS〉25%） according to the outcomes of CTA. CAS group was further divided into single-vessel group （with single coronary vessel lesion, n=30）, double-vessel group （with lesion of 2 coronary vessels, n=31）, 3-vessel group （with lesion of 3 coronary vessels, n=42）, mild-lesion group （n=55, CAS≤50%） and mid-severe-lesion group （n=48, CAS〉50%）. All patients were given examinations on ABI, TBI and LDL-C/HDL-C, and the changes of ABI, TBI and LDL-C/HDL-C and their values to estimating the severity of coronary artery lesion were analyzed in all groups. Results ABI and TBI had a descent trend and LDL-C/HDL-C had a ascent trend in control group, single-vessel group, double-vessel group and 3-vessel group, and comparison in ABI, TBI and LDL-C/HDL-C showed statistical difference （P〈0.05）. The comparison in ABI, TBI and LDL-C/HDL-C showed statistical difference among 3-vessel group, control group and single-vessel group （P〈0.05）. The comparison in ABI showed statistical difference between double-vessel group and control group （P〈0.05）. ABI and TBI had a descent trend and LDL-C/HDL-C had a ascent trend in control group, mild-lesion group and mid-severe-lesion group, and comparison in ABI, TBI and LDL-C/HDL-C showed statistical difference （P〈0.05）. The comparison in ABI, TBI and LDL-C/HDL-C showed statistical difference between mid-severe-lesion group and control group （P〈0.05）. The comparison in ABI showed statistical difference between mid-severe-lesion group and mild-lesion group and between mi

关 键 词：冠心病 踝臂指数 趾臂指数 低密度脂蛋白胆固醇 高密度脂蛋白胆固醇 

分 类 号：R541.4[医药卫生—心血管疾病]