心脏脚踝指数对冠状动脉粥样硬化的预测价值  

Prediction value of cardio-ankle vascular index in coronary arteriosclerosis

作　　者：欧邦豪 李博[2] 方胜先[2] 吴清华[3] 黄雪兰[2] 李家梅[2] 

机构地区：[1]深圳市大鹏新区南澳人民医院内科,广东深圳518121 [2]深圳市龙岗中心医院心内科,广东深圳518116 [3]南昌大学第二附属医院心内科,江西南昌330006

出　　处：《中国现代医生》2016年第20期13-17,共5页China Modern Doctor

基　　金：广东省深圳市龙岗区科技发展资金医疗卫生(扶持类)项目(YLWS20150513165735387)

摘　　要：目的讨论研究心脏脚踝指数（CAVI）、最大颈动脉内中膜厚度（MaxIMT）及平均颈动脉内中膜厚度（MeanIMT）对冠状动脉粥样硬化的预测诊断价值。方法选取我院心内科冠心病拟行冠状动脉造影（CAG）患者90例作为研究对象，根据CAG结果及Gensini评分，分为正常组A组（得分0分），B组（得分在1～80分）及C组（评分为81-160分），并以B、C组作为CAG阳性组。对三组人员分别进行空腹采血及CAVI、MaxIMT及MeanIMT。结果CAVI、MaxIMT及MeanIMT三项指标中，CAVI曲线下面积显然大于其余两项指标；其次为MaxIMT。说明CAVI预测动脉粥样硬化的价值显然高于其余两项指标。同时CAVI、MaxIMT及MeanIMT对预测粥样硬化的CUT—OFF值、敏感性及特异性分别为8．84、84．01％及69．00％；1．33、74．51％及74．00％；0．92、68．85％及73．22％。CAVI、MaxIMT及MeanIMT的三项评分均与Gensini评分呈正相关，评分分别为0．56（P〈0．01）、0．32（P〈0．05）、0．41（P〈0．01），其中CAVI与该项评分相关性最强。CAVI假阳性率显著低于MaxIMT及Mean IMT，CAVI阴性预测性显著高于其余两项指标，Mean IMT阴性预测值最小。结论CAVI相对于Max IMT及MeanIMT两个指标对判断动脉粥样硬化更具有预测价值，且该指数变化随动脉粥样硬化程度加重而逐渐升高，对临床判断冠心病及相关疾病风险具有重要意义。Objective To discuss the diagnostic value of cardiac ankle vascular index （CAVI）,the maximum carotid intima-media thickness（Max IMT）and mean internal intima-media thickness （Mean IMT） for predicting coronary ar- terioscleresis. Methods The 90 patients with cardiology coronary heart disease were undergone coronary angiography （CAG） as research subjects. According to the CAG results and Gensini score,the patients were divided into Group A （score of 0）, Group B（score 1 to 80） and Group C（rated between 81-160）, both B and C groups were positive group as CAG. The three groups of patients were fasted blood and CAVI, Max IMT and Mean IMT were detected. Results A- mong CAVI, Max IMT and Mean IMT, the area of CAVI under the curve was clearly greater than the remaining two in- dicators,followed by Max IMT. The predictive value of CAVI fort atherosclerosis is clearly higher than the other two indicators. Meanwhile, the CUT-OFF value, sensitivity and specificity with CAVI, Max IMT and Mean IMT to predict atherosclerosis were respectively 8.84,84.01% and 69.0%;1.33,74.51% and 74% ;0.92,68.85 %and 73.22%. The scores of CAVI,Max IMT and Mean IMT were positively correlated with Gensini scores, which was respectively 0.56 （P〈0.01） ,0.32（P〈0.05） and 0.41（P〈0.01）,in which the correlation was strongest of CAVI. The false rate of CAVI was significantly lower than that of Max IMT and Mean IMT. The negative predictive of CAVI was significantly higher than that of the other two indicators. Mean IMT was the minimum of negative predictive value. Conclusion CAVI compared with Max IMT and Mean IMT has more predictive value to judgment atherosclerosis, and the index varies with the de- gree of atherosclerosis gradually,which has important significance, on the clinical judgment of the risk of coronary heart disease and related disorders.

关 键 词：冠状动脉 粥样硬化 心脏脚踝指数 预测价值 

分 类 号：R541.4[医药卫生—心血管疾病]