踝臂指数与冠状动脉狭窄程度的相关性分析

【目的】探讨静息和运动后的踝臂指数（ankle brachial index，ABI）与冠状动脉狭窄程度的关系。【方法】选取在邵阳市中心医院心血管内科住院行冠状动脉造影患者120例，根据造影结果分为冠脉正常组（n=22）、轻-中度病变组（n=54）和严重病变组（n=44），检测三组患者的血脂、血糖指标，比较三组的静息ABI、运动后ABI、Gensini积分，并对静息ABI、运动后ABI与冠状动脉狭窄程度进行相关性分析。【结果】严重病变组的静息ABI、运动后ABI水平明显低于与正常组、轻中度病变组（均P〈0．05）；随病变程度增加Gensini积分显著增加（P均〈0．01）；静息ABI与运动后ABI与冠状动脉狭窄程度评分呈负相关（r=-0．55、-0．89，P〈0．01）。ROC分析显示运动ABI的ROC图曲线下面积（0．752）大于静息ABI的ROC图曲线下面积（0．646），但无统计学差异（P〉0．05）。【结论】静息ABI及运动后ABI水平与冠脉狭窄程度相关，以运动后ABI相关性更密切，运动后ABI对严重冠状动脉狭窄程度具有更高的诊断价值。

Analysis of the Correlation Between Ankle-brachial Index and Coronary Artery Stenosis

Objective] To explore the relationship between ankle-brachial index（ABI） at rest and after ex- ercise and coronary artery stenosis. Methods] Totally 120 patients receiving coronary angiography in central hospital of Shaoyang city were selected. According to coronary angiography, all patients were divided into nor- mal coronary artery group（ n = 22）, mild-m0derate lesion group （ n= 54） and severe lesion group （ n = 44）. Resting and postexercise ABI and Gensini score were compared among 3 groups. The correlation of resting and postexercise ABI with coronary artery stenosis was analyzed. Results] Resting and postexercise ABI in severe lesion group was obviously lower than that in normal group and mild-moderate lesion group （ P〈0. 05）. Gensini scores increased significantly with the increasing of lesion severity（ P〈0.01）. Resting and postexercise ABI was negatively related to coronary stenosis scores（r=-0.55, -0.89, P %0.01）. ROC analysis showed that the area under the curve of ROC of exercise ABI（0. 752） was larger than that of resting ABI （0. 646）, but there was no significant difference. Conclusion] Resting and postexercise ABI is related to coronary stenosis, and the correlation of postexercise ABI with coronary stenosis is closer. Postexercise ABI has higher value for the diagnosis of sever coronary artery stenosis.