心脏脚踝指数对冠状动脉粥样硬化预测价值.docVIP

心脏脚踝指数对冠状动脉粥样硬化预测价值 　　[摘要] 目的 讨论研究心脏脚踝指数（CAVI）、最大颈动脉内中膜厚度（Max IMT）及平均颈动脉内中膜厚度（Mean IMT）对冠状动脉粥样硬化的预测诊断价值。 方法 选取我院心内科冠心病拟行冠状动脉造影（CAG）患者90例作为研究对象，根据CAG结果及Gensini评分，分为正常组A组（得分0分），B组（得分在1～80分）及C组（评分为81～160分），并以B、C组作为CAG阳性组。对三组人员分别进行空腹采血及CAVI、Max IMT及Mean IMT。结果 CAVI、Max IMT及Mean IMT三项指标中，CAVI曲线下面积显然大于其余两项指标；其次为Max IMT。说明CAVI预测动脉粥样硬化的价值显然高于其余两项指标。同时CAVI、Max IMT及Mean IMT对预测粥样硬化的CUT-OFF值、敏感性及特异性分别为8.84、84.01%及69.00%；1.33、74.51%及74.00%；0.92、68.85%及73.22%。CAVI、Max IMT及Mean IMT的三项评分均与Gensini评分呈正相关，评分分别为0.56（P0.01）、0.32（P0.05）、0.41（P0.01），其中CAVI与该项评分相关性最强。CAVI假阳性率显著低于Max IMT及Mean IMT，CAVI阴性预测性显著高于其余两项指标，Mean IMT阴性预测值最小。 结论 CAVI相对于Max IMT及Mean IMT两个指标对判断动脉粥样硬化更具有预测价值，且该指数变化随动脉粥样硬化程度加重而逐渐升高，对临床判断冠心病及相关疾病风险具有重要意义。 　　[关键词] 冠状动脉；粥样硬化；心脏脚踝指数；预测价值 　　[中图分类号] R541.4 [文献标识码] A [文章编号] 1673-9701（2016）20-0013-05 　　[Abstract] Objective To discuss the diagnostic value of cardiac ankle vascular index（CAVI），the maximum carotid intima-media thickness（Max IMT）and mean internal intima-media thickness （Mean IMT） for predicting coronary arteriosclerosis. Methods The 90 patients with cardiology coronary heart disease were undergone coronary angiography （CAG） as research subjects. According to the CAG results and Gensini score，the patients were divided into Group A （score of 0）， Group B（score 1 to 80） and Group C（rated between 81-160）， both B and C groups were positive group as CAG. The three groups of patients were fasted blood and CAVI， Max IMT and Mean IMT were detected. Results Among CAVI，Max IMT and Mean IMT， the area of CAVI under the curve was clearly greater than the remaining two indicators，followed by Max IMT. The predictive value of CAVI fort atherosclerosis is clearly higher than the other two indicators. Meanwhile， the CUT-OFF value， sensitivity and specificity with CAVI， Max IMT and Mean IMT to predict atherosclerosis were respectively 8.84，84.01% and 69.0%；1.33，74.51% and 74%；0.92、68.85 %and 73.22%. The scores of CAVI，Max IMT and Mean IMT were positively correlated with Gensini sco