踝臂脉搏波速对冠心病的预测及筛查价值  

The value of ankle-brachial pulse wave velocity in predicting and diagnosing coronary heart disease

作　　者：唐世凡 董晓雁 程锡华 杨元 李婷 王艳芳 王朝晖[2] 

机构地区：[1]武汉市第三医院心内科,武汉430074 [2]华中科技大学同济医学院附属协和医院老年科

出　　处：《临床心血管病杂志》2017年第12期1186-1189,共4页Journal of Clinical Cardiology

基　　金：湖北省武汉市卫计委临床医学科研项目(WX10B04)

摘　　要：目的:通过对踝臂脉搏波速(baPWV)的检测分析,探究baPWV对冠心病的预测及临床筛查的价值。方法:从1 460例接受选择性冠状动脉(冠脉)造影或冠脉CTA检查的患者中,筛选出冠心病患者483例(CHD组),冠脉粥样硬化患者677例(AS组),冠脉血管正常者300例(NL组)。各组之间的baPWV比较采用t检验,相关性分析用Pearson检验;绘制baPWV预测及筛查冠心病的ROC特征曲线。结果:CHD组与AS、NL组之间的年龄、体质指数(BMI)、腰围、收缩压、脉压、餐后2h血糖、低密度脂蛋白胆固醇、超敏C反应蛋白、血尿酸、血肌酐等各项指标差异存在统计学意义(均P<0.05);CHD组与AS组、NL组之间的baPWV值差异存在统计学意义(P<0.05)。相关性分析显示,baPWV水平与冠心病患者危险因素呈正相关;ROC曲线显示,以baPWV对冠心病的发生进行预测,1 545cm/s为截断点,其中曲线下面积为0.703,标准误0.015(P<0.001);其灵敏度、特异度分别为89.8%和63.6%,阴性预测值(+PV)83.9%,阳性预测值(-PV)50.5%。结论:baPWV水平与冠心病患者的发病有着密切相关性,其对冠心病的预测和筛查具有重要的临床应用价值,有可能为冠心病患者未来的早期预防及治疗寻求新靶点提供更早、更可靠的科学依据。Objective：To explore the value of ankle-brachial pulse wave velocity（baPWV）in predicting and evaluating coronary heart disease（CHD）.Method：From 1 460 subjects who underwent selective coronary angiography or coronary CTA examination,483 cases with coronary heart disease were included into CHD group,677 cases with coronary atherosclerosis were included into AS group,and 300 cases with normal coronary vessels were included into NL group.The comparison of baPWV between three groups was used by t test,the correlation analysis was used by Pearson test,ROC curve was used to analyze the value of baPWV in prediction and screening of CHD.Result：There were statistical significant differences among CHD,AS and NL group in age,BMI,waist circumference,systolic blood pressure,pulse pressure,2-hour postprandial blood glucose,low density lipoprotein cholesterol（LDL-C）,hypersensitive c-reactive protein,blood uric acid and serum creatinine（all P〈0.05）.The difference of baPWV among three groups was statistically significant（P〈0.05）.Correlation analysis showed that the baPWV level was positively related with risk factors of CHD.ROC analysis showed that the area under was0.703 and the standard error was 0.015（P〈0.001）,the sensitivity and specificity were 89.8% and 63.6%,the negative predictive value（＋PV）was 83.9% and the positive predictive value（-PV）was 50.5% when the cutoff value was 1 545 cm/s.Conclusion：The baPWV level is closely related to CHD.The level of baPWV has important clinical value in screening and predicting of CHD.baPWV could provide an earlier and more reliable scientific basis to find a new target for CHD prevention and treatment.

关 键 词：冠心病 踝臂脉搏波速 预测 筛查 

分 类 号：R541.4[医药卫生—心血管疾病]