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|本期目录/Table of Contents|

颈动脉斑块及主动脉脉压与冠状动脉病变严重程度的相关性及预测价值

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第4期
页码:
569-571,575
栏目:
临床研究
出版日期:
2010-06-10

文章信息/Info

Title:
Relevance and predictive value of aortic plaque and aortic pulse pressure to degree of coronary disease
作者:
马林业1; 骆金玺1; 魏琦1; 高传玉2
1.许昌市人民医院心内科，河南 许昌 461000；2.河南省人民医院心内科，河南 郑州 450003
Author(s):
MA Lin-ye1;  LUO Jin-xi1;  WEI Qi1;  GAO Chuan-yu2
1.Department of Cardiology, Xuchang City People’s Hospital, Xuchang 461000, Henan, China; 2.Department of Cardiology, Henan provincial people’s Hospital, Zhengzhou 450003, Henan, China
关键词:
主动脉脉压; 颈动脉斑块; 冠状动脉病变积分
Keywords:
aortic pulse pressure;  carotid artery plaque;  coronary artery score
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的: 探讨颈动脉斑块及主动脉脉压(PP)与冠状动脉病变严重程度的相关性和预测价值。方法: 将276例均行冠脉造影、主动脉压测量、颈动脉超声的患者资料回顾性分析，根据有无颈动脉斑块和PP水平≥或<65 mmHg分为4组:无颈动脉斑块＋PP<65 mmHg组，无颈动脉斑块＋PP≥65 mmHg组，颈动脉斑块＋PP<65 mmHg组和颈动脉斑块＋PP≥65 mmHg组，进行比较分析。结果: 4组间年龄、血压、血脂有显著差异(P<0.05，P<0.01)；多元线性逐步回归分析显示：年龄、PP、颈动脉斑块与冠脉积分正相关；颈动脉斑块和PP增大预测冠脉病变严重程度的敏感性为81% vs. 77%、特异性为93% vs. 91%、阳性预测值为57% vs. 51%和阴性预测值为98% vs. 97%，二者结合可提高敏感性（90%）和阳性预测值（77%，均P<0.05）。结论: 颈动脉斑块联合PP可更好地预测冠脉病变严重程度。
Abstract:
AIM: To study the relevance of carotid artery plaque (CAP) and aortic pulse pressure (PP) to the degree of CHD and to explore their predictive values. METHODS: A total of 276 patients with suspected CHD who underwent carotid artery ultrasound and coronary angiography were divided into four groups according to CAP and the level of PP: 1) positive CAP with PP≥65 mmHg group; 2) negative CAP with PP≥65 mmHg group; 3) positive CAP with PP<65 mmHg group; 4) negative CAP with PP<65 mmHg group. RESULTS: Significant differences were found in age, PP and LDL-C among the four groups (P<0.05). More three-vessel lesions were found in the first group, whereas more singe-vessel lesions were found in the fourth group. No significant difference was found in double-vessel lesions among all groups. Logistic multivariate analysis showed that age, LDL-C, PP and plaque were significantly related to coronary artery score (CAS). For the value of CAP and PP in predicting the presence of CHD, sensitivity was 81 vs. 77%, specificity was 93 vs. 91%, positive predictive value was 57 vs. 51%, and negative predictive value was 98 vs. 97%. The combination of these two parameters enhanced sensitivity to 90% and positive predictive value to 77%. CONCLUSION: The combination of CAP and PP is of higher diagnostic value in assessing the degree of CHD.

参考文献/References

［1］Kotsis V, Pitiriga V, Stabouli S, et al. Carotid artery intimamedia thickness could predict the presence of coronary artery lesions［J］. Am J Hypertens, 2005, 18(5 Pt 1): 601-606.

［2］ 朱中玉,高传玉,张嘉莹,等. 脉压与冠状动脉病变严重程度关系的探讨［J］. 中国心血管病研究杂志， 2004, 2(2)：126-128.

［3］Munir S, Guilcher A, Kamalesh T, et al. Peripheral augmentation index defines the relationship between central and peripheral pulse pressure［J］. Hypertension, 2008, 51(1):112-118.

［4］Hamsten A, Walldius G, Szamosi A, et al. Relationship of angiographically defined coronary artery disease to serum lipoproteins and apolipoproteins in young survivors of myocardial infarction［J］. Circulation, 1986, 73(6):1097-1100.

[5]Frankin S, Khan S, Wong N, et al. Is pulse pressure useful in predicting risk for coronary heart disease: the Franingham Heart Study［J］. Circulation, 1999, 100(3):354-360.

[6] Safar ME, Blacher J, Protogerou A, et al. Arterial stiffness and central hemodynamics in treated hypertensive subjects according to brachial blood pressure classification［J］. J Hypertens, 2008, 26(1):130-137.

备注/Memo

备注/Memo:
收稿日期：2008-09-25.作者简介：马林业，主治医师，硕士Email：lyma756@126.com
更新日期/Last Update: 2010-05-20