踝臂指数及心踝血管指数对冠状动脉病变的诊断价值

目的评价踝臂指数(ankle brachial index,ABI)与心踝血管指数(cardio-ankle vascular index,CAVI)对冠状动脉病变的诊断价值。方法选择2012年6月至2012年11月在重庆医科大学附属第一医院心血管内科住院,因拟诊为冠状动脉粥样硬化性心脏病(冠心病)而行冠状动脉造影的127例患者,根据冠状动脉造影结果,88例冠状动脉狭窄患者列入冠状动脉病变组(D组):根据狭窄程度,将患者分为轻度病变亚组(A组,31例),中重度病变亚组(B组,57例);依累及血管支数,分为单支病变亚组(22例),双支病变亚组(26例),三支病变亚组(40例)。对照组为39例冠状动脉造影阴性患者。入选患者接受ABI及CAVI检测,比较分析各组间ABI及CAVI。结果对照组、A组、B组3组比较,ABI依次降低,且对照组、A组、B组两两比较差异有统计学意义(P<0.05)。CAVI在对照组、A组、B组3组数值依次增高,但两两比较差异无统计学意义(P>0.05);但D组与对照组比较CAVI明显升高,且差异有统计学意义(P<0.05)。对照组、单支病变组、双支病变组、三支病变组4组ABI值依次降低,对照组与各病变组ABI值差异有统计学意义(P<0.05),但各病变组之间两两比较差异无统计学意义(P>0.05)。在各组中随病变范围增大,CAVI数值并未依次增高,且各病变组两两比较差异无统计学意义(P>0.05)。结论 ABI值能很好地反映病变狭窄程度,ABI数值越低,冠状动脉狭窄程度越重,但无法反映病变范围;CAVI既不能反映冠心病的病变程度,也无法反映病变范围。

Diagnosis value of ankle brachial index and cardio-ankle vascular index on coronary artery disease

Objectives To evaluate the diagnosis value of ankle brachial index （ABI） and cardio-ankle vascular index （CAVI） on coronary heart disease （CHD）. Methods Totally 126 patients performed coronary angiography （CAG） because of suspecting coronary heart disease were selected randomly from The First Affiliated Hospital of Chongqing Medical University from June 2012 to November 2012. According to the results of CAG, 88 patients with coronary artery stenosis were in CHD group （group D）. Among the 88 patients, 31 patients were in mild lesions groups （group A） and 57 patients were in moderate and severe lesions groups （group B） according to the stenosis degree; according to the numbers of coronary artery lesion, they were divided into single-vessle group （n=22）, double-vessel group （n=26） and three-vessle group （n=40）. Control group included 39 patients with negative results of CAG. ABI and CAVI of all the patients were measured and compared. Results ABI values of control group, group A and group B reduced in turn, and the differences among the 3 groups were significant （P〈0.05）. CAVI values of control group, group A and group B increased in turn, but the differences among the 3 groups were not significant （P〉 0.05）, while CAVI value of group D was significant higher than that of control group （P〈0.05）. ABI values of control group, single-vessle group, double-vessel group and three-vessle group reduced in turn, and the differences between control group and the 3 groups were significant （P〈0.05）, but the differences among the 3 groups were not significant（P〉0.05）. Differences of CAVI values among control group, single-vessle group, double-vessel group and three-vessle group were not significant （P〉0.05）. Conclusions ABI reflects the severity of coronary artery stenosis and is non-invasive, but can not reflect the extent of coronary artery stenosis. CAVI can not reflect neither the severity of coronary artery stenosis nor the extent of coronary artery stenosis.