肱-踝脉搏波传导速度与冠状动脉粥样硬化相关性的临床研究

目的探讨冠心病患者肱-踝脉搏波传导速度（baPWV）与冠状动脉粥样硬化及其病变程度的关系。方法将102例行冠脉造影的患者分为冠心病组和对照组，冠心病组按冠状动脉病变程度分为单支、双支和严重病变组。所有患者在冠脉造影前应用脉搏波速度测量系统测量baPWV。结果冠心病组baPWV值（1603．75±223．99）cm／s明显高于对照组（1328．37±178．52）cm／s，（P〈0．05）。应用Logistic回归分析显示在校正动脉粥样硬化多种危险因素后，baPWV的OR值为1．009，（95％CI：1．005—1．013，P〈0．010）。进一步分析baPWV以1400cm／s作为组界进行Logistic逐步回归分析，结果显示baPWV≥1400cm／s的患者发生冠心病的危险度是baPWV〈1400cm／s者的12．723倍（95％cI：4．625—34．997，P〈0．001）。冠状动脉病变程度分析中，aPWV在冠状动脉单支病变组（1437．78±221．89）cm／s即已明显高于对照组（1328．37±178．52）cm／s（P〈0．05）；严重病变组（1674．98±211．28）cm／s和双支病变组（1667．65±161．78）cm／s明显高于单支病变组和对照组（P〈0．05）。严重病变组baPWV和双支病变组组间比较没有明显差异性（P〉0．05）。结论baPWV与冠状动脉粥样硬化密切相关，baPWV升高可能是冠状动脉粥样硬化新的预测因子之一，检测baPWV在一定程度上能反映冠脉的病变程度。

Clinical study on the relation between brachial-ankle pulse wave velocity and coronary atherosclerosis

Objective To investigate the association between brachial-ankle pulse wave velocity （baPWV） and coronary atherosclerosis and the degree of coronary atherosclerosis in patients with coronary heart disease（CHD） .Methods 102 patients who were performed by coronary angiography（CAG） were divided into two groups according to the result of CAG： coronary heart diseas group cm/s and control group. Coronary heart disease group was divided into single-vessel group ,dual-vessel group and multiple-ves- sel group in term of the extent of coronary artery. A measurement of brachial-ankle artery pulse wave velocity （baPWV） using a Colin system before CAG.Results The baPWV value was significantly higher in coronary heart disease group（1 603.75± 223.99）cm/s compared with that in control group（ 1 328.38 ± 178.52） cm/s, （ P 〈 0.05 ）. Logistic regression analysis demonstrated that baPWV was a new marker of cardiovascular risk independently from conventional atheroselerotic risk factors. （ OR = 1. 009,95 % CI ： 1. 005 - 1.013, P 〈 0.01 ）. Further analysis baPWV value with a cutoff of 1 400 cm/s showed that the hazards ratios of CHD in subjects with baPWV value （ ≥ 1 400 cm/s） compared to those with baPWV value （ 〈 1 400 cm/s） was 12.723. （95%CI：4.625 - 34.997, P 〈 0.001 ）. In the analysis of the degree of coronary artery disease, baPWV value in single-vessel disease group （ 1 437.78 ± 221.89） cm/s was higher than control group （1 328.37± 178.52） cm/s, （P 〈 0.05）. The baPWV values in those with multiple-vessel dis- ease group （1 674.98 ± 211.28）cm/s and dual-vessel disease group （1 667.65 ± 161.78）cm/s were respectively higher than those with single-vessel disease group and control group （P 〈 0.05）. However, not significantly between multiple-vessel disease group and dual-vessel disease group（ P 〉 0.05）. Conclusion baPWV value is strongly related with coronary atherosclerosis and may be a new a predictor of atherosclerosis, furthermore, the increase of the baPWV value to a degree is significantly associated with the severe degree of the coronary atherosclerosis.