冠心病患者CAVI与ABI改变的临床研究

目的探讨冠状动脉粥样硬化性心脏病（CHD,冠心病）患者在动脉硬化及僵硬度指标心踝血管指数（cardio-ankle vascular index,CAVI）与踝臂指数（ankle-brachial index,ABI）改变的临床价值。方法随机选取在安徽医科大学第一附属医院心血管内科行选择性冠状动脉造影检查及治疗的患者269例,其中经冠脉造影证实的冠心病患者（狭窄≥50%）217例作为实验组（冠心病组）,并根据冠状动脉血管病变支数分为相应的亚组,其余52例（狭窄〈50%）作为对照组（非冠心病组）,比较两组间在CAVI、ABI的差异。结果①随着冠状动脉狭窄程度的加重,CAVI进行性增高,组间的差异有统计学意义（P〈0.01）。②非冠心病组与冠心病组的ABI均在正常范围,但冠心病组的ABI低于非冠心病组（P〈0.01）。多支病变组ABI低于对照组、单支病变组（P〈0.05）。③CAVI（＋）预测冠心病的敏感性较高（66.4%）,特异性欠佳（32.7%）;ABI降低预测冠心病的敏感性低（18.0%）,但特异性高（96.2%）。结论 CAVI（-）可能是非冠心病有意义的独立预测因子,CAVI（＋）有利于早期发现动脉硬化,ABI降低是冠心病独立的危险因子,可作为冠心病诊断参考指标。

Correlation between changes of coronary heart disease and cardio-ankle vascular index and ankle-brachial index

Objective To explore the research value of changes of arteriosclerosis cardio-ankle vascular index （CAVI） and ankle-brachial index （ABI） in the patients with coronary heart disease （CHD）.Methods The patients （n=269） were randomly selected who had coronary angiography examination and treatment in the Department of Cardiovasology of the First Affiliated Hospital of Anhui Medical University.Among them 217 with CHD confirmed by angiography enclosed in the CHD group （with proportion of stenosis≥50%）,and other 52 enclosed in the non-CHD group （with proportion of stenosis50%）.The CHD group was divided again into the corresponding sub-group according to the number of diseased branches.The differences of CAVI and ABI were compared between two groups.Results ①With the aggravation of coronary stenosis,CAVI increased progressively.The difference between two groups was significant statistically （P0.01）.②ABI was in normal range in two groups but lower in the CHD group than that in the non-CHD group （P0.01）.ABI was lower in the multiple-branch disease group than that in the non-CHD group and single-branch disease group （P0.05）.③CAVI （＋） was sensitive to predict CHD （66.4%） but the specificity was poor （32.7%）.ABI was not sensitive to predict CHD （18.0%） but the specificity was high （96.2%）.Conclusion CAVI （-） may be an independent and significant predicting factor for non-CHD,and CAVI （＋） can help to find atherosclerosis early.The decrease of ABI is an independent and risk factor,which can be taken as one of indexes for CHD diagnosis.