评价桡动脉反射波增强指数与冠心病及病变程度的关系

目的分析桡动脉反射波增强指数(radial augmentation index,rAI)与冠心病、冠脉病变严重程度的关系,探讨无创法检测桡动脉脉搏波增强指数的临床价值。方法于2009年2月至2009年4月间非连续性纳入150例接受冠状动脉造影检查的患者,年龄为(64.2±10.3)岁,其中男性101例。收集患者的一般及临床资料,并根据冠脉造影结果计算Gensini积分评价冠脉病变程度。应用基于平面压力测定原理的无创测量仪按照标准方法检测桡动脉脉搏波形获得rAI,并记录由仪器内置软件计算出的按照心率为75次标准化的rAI值(rAIP75),分析其与冠心病、冠脉病变严重程度的关系。结果冠心病组(119例)的rAIP75(80.42±11.33)%显著高于非冠心病组(31例)的rAIP75(74.65±13.96)%,P=0.017;Logistic回归分析示rAIP75与冠心病发病显著相关(OR=1.041,95%CI=1.005～1.079,P=0.026)。多元线性回归分析显示rAIP75与Gensini积分呈显著正相关,标准化偏回归系数0.363(95%CI0.684～1.713,P<0.001)。结论 rAIP75升高与冠心病发病及冠脉病变程度显著相关,提示动脉僵硬度一定程度上可反映冠脉粥样硬化的严重程度,可能成为冠心病及病变程度的无创评价指标之一。

Association of radial augmentation index with coronary heart disease

Objective To evaluate radial augmentation index(rAI) measured with a non-invasive applanation tonometry equipment,analyzing its association with coronary heart disease(CHD) and the severity of coronary stenosis.Methods 150 cases undergoing coronary angiography(CAG) were recruited from Feb.2009 to Apr.2009,of whom 101 males and 49 females,with average age of 64.2±10.3 years old.119 cases were confirmed CHD by CAG and the other 31 subjects were excluded.The patients’ clinical information was collected,and Gensini score was calculated according to the result of coronary angiography.Radial augmentation index(rAI) was measured with an applanation tonometry equipment noninvasively,and heart rate standardized rAI(rAIP75) was required from the equipment’s programme.Results rAI adjusted to a heart rate of 75 bpm(rAIP75) was higher in CHD group(n=119) than in non-CHD group(n=31)(80.42±11.33% vs.74.65±13.96%,P=0.017),and logistic regression indicated that rAIP75 value was significantanly associated with CHD(OR=1.041,95% CI 1.005-1.079,P=0.026).On multiple linear regression analysis,Gensini score was associated with rAIP75,partial regression coefficient was 0.363(95% CI 0.684-1.713,P<0.001).Conclusion Elevated rAIP75 is associated with CHD morbidity and the severity of coronary lesion.