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高血压患者踝臂指数与冠状动脉狭窄严重程度的相关性研究
引用本文:张红,梁军,郭永和. 高血压患者踝臂指数与冠状动脉狭窄严重程度的相关性研究[J]. 中国循证心血管医学杂志, 2010, 2(4): 228-231. DOI: 10.3969/j.issn.1674-4055.2010.04.009
作者姓名:张红  梁军  郭永和
作者单位:1. 北京化工职业病防治院,北京,100093
2. 山东省东平县人民医院
3. 首都医科大学附属北京安贞医院
摘    要:目的观察老年高血压患者踝臂指数与冠状动脉狭窄严重程度的相关性,评价踝臂指数对冠状动脉狭窄严重程度的预测价值。方法连续入选156例接受冠状动脉造影检查的老年高血压患者(年龄≥65岁)进行研究,根据冠状动脉造影结果分为无病变组(16例)、单支病变组(20例)、2支病变组(28例)、3支或左主干病变组(92例)。对所有患者进行病史采集、血液化验检查和踝臂指数测量,并对踝臂指数与冠状动脉Gensini评分做相关分析。结果踝臂指数与Gensini评分呈负相关;冠状动脉3支或左主干病变组患者踝臂指数显著降低(P〈0.01),而造影正常、单支病变或2支病变组患者踝臂指数无显著差异;评价踝臂指数对3支或左主干病变预测价值的ROC曲线下面积为(0.79±0.036),95%可信区间为(0.69~0.85,P〈0.001);踝臂指数≤0.9作为截断值预测3支或左主干病变具有相对高的特异性(89.5%)和敏感性(53.6%)。结论老年高血压患者踝臂指数与冠状动脉狭窄严重程度呈负相关,踝臂指数≤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。

关 键 词:踝臂指数  老年  Gensini评分  ROC曲线  高血压  冠状动脉病变

Correlation between ankle-brachial index and coronary stenosis in hypertension patients
ZHANG Hong,LIANG Jun,GUO Yong-he. Correlation between ankle-brachial index and coronary stenosis in hypertension patients[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2010, 2(4): 228-231. DOI: 10.3969/j.issn.1674-4055.2010.04.009
Authors:ZHANG Hong  LIANG Jun  GUO Yong-he
Affiliation:.Beijing Chemical Industry Institute of Occupational Disease Prevention,Beijing 100093,China.
Abstract:Objective To observe the correlation between ankle-brachial index (ABI) and degree of coronary stenosis in senile hypertension patients,and review the predictive value of ABI to the degree of coronary stenosis.Methods The senile hypertension patients (n=156,aged 65 or elder) having coronary angiography examination were selected and divided into the normal group (n=16),1-vessel group (n=20),2-vessel group (n=28) and 3-vessel or left main trunk group (n=92) according to the outcomes of coronary angiography.All patients were given history collection,blood test and ABI examination.The correlation between ABI and Gensini scores of coronary artery were analysed.Results ABI and Gensini scores showed a negative correlation.ABI decreased significantly in the 3-vessel or left main trunk group (P0.01) but did not change in the normal group,1-vessel group and 2-vessel group.The corresponding area under ROC curve was 0.79±0.036 with 95%CI (0.69~0.85,P0.001).When ABI was 0.9 or lower,as a cutoff score,it had relatively higher specificity (89.5%) and sensitivity (53.6%) for predicting the disease of 3-vessel or left main trunk.Conclusion ABI and the degree of coronary stenosis is negatively related in senile hypertension patients.ABI (≤0.9) has higher specificity and sensitivity for predicting the disease of 3-vessel or left main trunk.
Keywords:Ankle-brachial index  Senile  Gensini scores  ROC curve  Hypertension  Coronary artery disease
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