踝臂指数与老老年患者冠状动脉狭窄程度的相关性研究

目的探讨老老年冠心病患者踝臂指数(ABI)与冠状动脉狭窄严重程度的相关性,评价ABI对冠状动脉狭窄严重程度的预测价值。方法连续入选78例冠状动脉造影的老老年患者(年龄≥80岁)进行研究,根据冠状动脉造影结果分为无病变者(8例)、单支病变患者(10例)、2支病变患者(14例)、3支或左主干病变患者(46例)。对所有患者进行ABI测量、病史采集及血液生化检测。结果 ABI与Gensini评分呈负相关;冠状动脉3支或左主干病变患者ABI显著降低,差异有统计学意义(P0.001),而无病变、单支病变、2支病变患者ABI差异无统计学意义;ABI对3支或左主干病变预测价值的ROC曲线下面积为(0.79±0.04,95% CI:0.69～0.85,P0.001);ABI≤0.9作为截断值预测3支或左主干病变具有较高的特异性(89.5%)和敏感性(53.6%)。结论老老年冠心病患者ABI与冠状动脉狭窄严重程度呈负相关,ARI≤0.9对预测冠状动脉3支和左主干病变具有较高的特异性和敏感性。

Relationship between ankle-brachiai index and extent of coronary stenosis in the very elderly

Objective To examine the relation between ankle-brachial index(ABI) and the extent of coronary stenosis and evaluate the usefulness of ABI for predicting the extent of coronary stenosis in very elderly.Methods Seventy-eight consecutive patients(age≥80) who were referred for coronary angiography were studied.All patients underwent ABI evaluation and blood biochemical examination in addition to history collection.Results ABI was inversely correlated with Gensini score.ABI reduced significantly (P <0.001) in patients with 3-vessel or left main trunk CAD, but among patients with no CAD,1-vessel or 2-vessel CAD,there was no significant difference in ABI.The corresponding area under the ROC curve in 3-vessel or main trunk CAD was 0.79 ± 0.04(95% CI 0.69 — 0.85,P < 0.001).ABI≤0.9 had a relatively high specificity(89.5%) and sensitivity(53.6%) for predicting the presence of 3-vessel disease or left main trunk CAD.Conclusion In very old patients ABI is inversely and significantly correlated with the extent of coronary stenosis,and ABI≤0.9 has a relatively high specificity and sensitivity for predicting the presence of 3-vessel or left main trunk CAD.