【作者】 陈保见；

【导师】 韩卫星；

【作者基本信息】 安徽医科大学 ， 内科学， 2011， 硕士

【摘要】 目的:探讨冠心病患者在动脉硬化及僵硬度指标心踝指数(cardio-ankle vascular index,CAVI)与踝臂指数(ankle-brachial index,ABI)上改变的研究价值,并研究CAVI与ABI在普通体检人群中的变化规律。方法:随机选取在我院心血管内科行选择性冠脉造影检查及治疗的患者342例,其中经冠脉造影证实的冠心病患者(狭窄≥50%)275例作为实验组(冠心病组),根据冠脉血管病变支数分为相应的亚组,其余67例(狭窄<50%)作为对照组(非冠心病组包括31例冠脉造影完全正常),比较两组间在CAVI、ABI上的差异,随机选择我院体检人群1123人,依据年龄段分组,比较它们在CAVI与ABI上的差异性。结果:(1)年龄、糖尿病、高血压、吸烟、血脂等是冠心病发生的危险因素。(2)随着冠脉狭窄程度的加重,CAVI进行性增高,组间的差异有统计学意义(P<0.01)。(3)非冠心病组与冠心病组的ABI均在正常范围,但冠心病组的ABI低于非冠心病组(P<0.01)。多支病变组ABI低于对照组、单支病变组(P<0.05)。(4)CAVI(+)预测冠心病的敏感性较高(66.4%),特异性欠佳(32.7%);ABI降低预测冠心病的敏感性低(18.0%),但特异性高(96.2%)。(5)在普通体检人群中同样随着年龄的增加CAVI值进行性增高,但ABI值由先升高而后减低,即在60至70岁年龄段内出现拐点。结论:CAVI(-)可能是非冠心病有意义的独立预测因子,CAVI(+)则有利于早期发现动脉硬化,而ABI降低则是冠心病独立的危险因子,可视为冠心病的诊断参考指标,60至70岁的老年人,ABI值小于1.16提示有发生下行动脉系统狭窄的可能性。更多还原

【Abstract】 Objective: Discuss the values research of change on patients with coronary artery disease in arteriosclerosis and stiffness index Cardio-Ankle Vascular Index (cardio-ankle vascular index CAVI) and ankle-brachial index (ankle-brachial index ABI), Studies CAVI and ABI in the ordinary physical examination crowd’s change rule.Methods: A randomly selected Cardiology in our hospital underwent selective coronary angiography examination and treatment of 342 patients, which confirmed by coronary angiography in patients with coronary heart disease (stenosis≥50%) 275 were used as the experimental group (CHD group) and coronary artery disease according to the count into the corresponding sub-group, and the remaining 67 cases (stenosis<50%) as a control group (non-CHD group Including 31 example crown arteries radiography complete normal person) were compared between the two groups in the CAVI,ABI differences. Random selection my courtyard physical examination crowd 1123 people, the basis age section grouping, compared with them on CAVI and ABI difference.Results: (1) confirmed that age, diabetes, hypertension, smoking, blood lipids are risk factors for coronary heart disease. (2) With the severity of coronary stenosis, CAVI progressive increase, the difference between the groups was statistically significant (P <0.01). (3) non-CHD group and the CHD group were in the normal range of ABI, but the CHD group ABI lower than without CHD (P <0.01). ABI multiple vessel disease group than the control group, single-vessel disease group (P <0.05). (4) CAVI (+) predicted a higher sensitivity of coronary heart disease (66.4%), poor specificity (32.7%); ABI prediction of coronary heart disease reduce the low sensitivity (18.0%), but high specificity (96.2% .). (5) Increases the CAVI value along with the age to carry on the markup in the ordinary physical examination crowd,but The ABI value by elevates first then decreases, Namely in 60 to 70 year old of age section presents the inflection point.conclusion: CAVI (-) maybe non-significant independent predictor of coronary heart disease, CAVI (+) it will help early detection of atherosclerosis, and reduced ABI is an independent risk factor for coronary heart disease, can be regarded as Reference index for the diagnosis of coronary artery disease, 60 to 70 year-old senior citizen, the ABI value is smaller than 1.16 prompts has the downward artery system narrow possibility.更多还原