老年冠心病患者冠状动脉病变程度与踝臂指数 中心动脉压及肱-踝脉搏波传导速度的相关性探讨  被引量:10

Correlation between coronary artery disease severity,ankle brachial index,central arterial pressure and brachial-ankle pulse wave velocity in elderly patients with coronary heart disease

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作  者:张朝富[1] 刘萍[1] 夏莉[1] 尹维斌 余敏[1] Zhang Chaofu;Liu Ping;Xia Li;Yin Weibin;Yu Ming(Department of Cardiology,Ziyang People's Hospital,Ziyang,Sichuan 641300,China)

机构地区:[1]四川省资阳市人民医院心血管内科,资阳641300

出  处:《中华老年医学杂志》2020年第5期526-529,共4页Chinese Journal of Geriatrics

摘  要:目的分析老年冠心病不同病变程度患者的踝臂指数(ABI)、中心动脉压(CAP)和肱-踝脉搏波传导速度(baPWV)水平差异,为老年冠心病患者病情评估提供依据。方法在2018年1月至2019年7月本院心内科所收治老年冠心病患者中抽取52例作为观察对象,按照病变程度将其分为A组(轻度,单支病变)、B组(双支病变)、C组(3支及以上、主干病变),另选取正常人32例(冠状动脉狭窄程度<50%)作为对照组,对3组受试对象的ABI、中心动脉压(CAP)和baPWV进行测定比较。结果观察组ABI[(1.01±0.14)和(1.12±0.15),t=-3.403,P=0.001]低于对照组,CAP[(63.9±11.8)mmHg和(56.3±10.5)mmHg,t=2.987,P=0.002]、baPWV[(1675.9±259.5)cm/s和(1517.2±283.4)cm/s,t=2.628,P=0.005]高于对照组。A组、B组、C组和对照组ABI分别为[1.07±0.13、0.95±0.14、0.92±0.17和1.12±0.15,F=12.118,P=0.085];baPWV分别为(1685.2±276.8)cm/s、(1680.8±255.4)cm/s、(1667.4±232.6)cm/s和(1517.2±283.4)cm/s(F=0.573,P=0.061);CAP分别为(62.7±12.3)mmHg、(64.2±11.5)mmHg、(69.1±10.6)mmHg和(56.3±11.8)mmHg,(F=1.212,P=0.053)。ABI水平B组、C组高于对照组(t=3.938,P=0.000;t=-5.534,P=0.000);A组患者baPWV水平高于对照组(t=2.628,P=0.005)。A组(t=2.349,P=0.011)、B组(t=2.293,P=0.013)、C组(t=3.697,P=0.000)患者CAP水平均高于对照组,且A组、B组、C组之间并无明显差异(F=1.212,P=0.053)。结论CAP、baPWV可作为老年冠心病的诊断依据,对于冠心病病变程度的鉴别特异性较差;ABI在不同病变程度的冠心病患者之间存在明显差异,可作为患者病情严重程度的评估依据。Objective To analyze the differences in ankle brachial index(ABI),central arterial pressure(CAP)and branchial-ankle pulse wave velocity(baPWV)in elderly patients with different degrees of coronary heart disease(CHD),and to provide a basis for the assessment of CHD.Methods From January 2018 to July 2019,52 elderly patients with CHD treated in our hospital were selected as the observation group,and divided into Observation Group A(mild,single-vessel disease),Observation Group B(double-vessel lesions)and Observation Group C(multivessel lesions or trunk lesions).Besides,32 healthy people(the degree of coronary artery stenosis<50%)were selected as the control group.ABI,CAP and baPWV were measured and compared.Results Patients in the observation groups were associated with significantly lower ABI[(1.01±0.14)vs.(1.12±0.15),t=-3.403,P=0.001]and higher CAP[(63.9±11.8)mmHg vs.(56.3±10.5)mmHg,t=2.987,P=0.002]and baPWV[(1675.9±259.5)cm/s vs.(1517.2±283.4)cm/s,t=2.628,P=0.005]than those in the control group.For patients in Observation Groups A,B,C and the control group,the ABI values were(1.07±0.13,0.95±0.14,0.92±0.17 and 1.12±0.15,F=12.118,P=0.085),the baPWV values were(1685.2±276.8)cm/s,(1680.8±255.4)cm/s,(1667.4±232.6)cm/s and(1517.2±283.4)cm/s(F=0.573,P=0.573),and the CAP values were(62.7±12.3)mmHg,(64.2±11.5)mmHg,(69.1±10.6)mmHg and(56.3±11.8)mmHg,respectively(F=1.212,P=0.053).ABI levels in Observations Groups B and C were higher than those in the control group(t=3.938,P=0.000;t=-5.534,P=0.000).Additionally,levels of baPWV in Observation Group A was higher than in the control group(t=2.628,P=0.005),and CAP levels in Observation Groups A(t=2.349,P=0.011),B(t=2.293,P=0.013),C(t=3.697,P=0.000)were significantly higher than in the control group,though there was no significant difference between the observation groups(F=1.212,P=0.053).Conclusions CAP and baPWV have the potential to be used as diagnostic parameters for elderly CHD patients,but their specificity for detecting the degree of coronary stenosis is

关 键 词:冠心病 动脉硬化 

分 类 号:R541.4[医药卫生—心血管疾病]

 

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