脉搏波传导速度和颈动脉粥样硬化对冠心病诊断价值的研究.pdfVIP

暨南大学硕士研究生论文 脉搏波传导速度和颈动脉粥样硬化对冠心病诊断价值的研究 摘要 目的 探讨臂踝脉搏波传导速度（brachial-ankle pulse wave velocity, baPWV ）和颈动脉粥样硬 化对冠心病的诊断价值。 方法 106 例受试者完成 baPWV 检测和颈动脉彩色超声检测，再完成经皮选择性冠状动脉造 影。所有受试者按冠状动脉造影结果分为冠心病组和非冠心病组，冠心病组再分为单支病 变、二支病变和三支病变共三个亚组。计算 baPWV 值诊断冠心病的截断点及敏感度和特 异度，计算 baPWV 超出年龄和性别预测值百分数诊断冠心病的截断点及敏感度和特异度； 分析颈动脉粥样硬化对冠心病诊断的敏感度和特异度；联合二者分析平行试验时对冠心病 诊断的敏感度和特异度；并对不同冠心病亚组进行组间分析。 结果 运用接受者工作特征（receiver operator characteristic, ROC ）曲线求得曲线下面积为 0.655， baPWV 超出年龄预测值百分数为 22.5 时获得最大准确度，其对冠心病诊断的敏感 度为 63.2%，特异度为 61.8% ；颈动脉粥样硬化对冠心病诊断的敏感度为 88.5%，特异度 为 68.4% ；联合二者平行试验对冠心病诊断的敏感度提高为0.958，而特异度降低为 0.432 ； 冠心病亚组分析，随着冠状动脉病变程度加重，baPWV 逐渐增快，颈动脉粥样硬化检出率 明显增高。 结论 联合 baPWV 和颈动脉粥样硬化检测可以初步评估受试者患冠心病的可能性，可作为 有创的冠脉造影检查前的无创筛查手段。 关键词 臂踝脉搏波传导速度；颈动脉粥样硬化；冠心病 I 暨南大学硕士研究生论文 脉搏波传导速度和颈动脉粥样硬化对冠心病诊断价值的研究 Abstract Objective To explore the diagnosis value of brachial-ankle pulse wave velocity(baPWV) and carotid atherosclerosis in coronary artery disease. Methods 106 subjects achieved the test of baPWV, the color Doppler detection carotid artery and percutaneous selective coronary angiography. All patients were divided into group of non-coronary heart disease and group of coronary heart disease according to the results of coronary angiography. Coronary heart disease group was further divided into three sub-groups: single-vessel lesions group, two rami lesions group and three rami lesions group. baPWV value for cut-off point, the sensitivity and specificity of coronary heart disease’s diagnosis was calculated . The percentage of baPWV beyond the predictive value of age and sex to diagnose of coronary heart disease’s cut-off point and the sensitivity and specificity was calculated.