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目的:探讨臂踝脉搏波传导速度(baPWV)和颈动脉粥样硬化对冠心病(CHD)的诊断价值。方法:106例患者行baPWV检测和颈动脉彩色超声检测,再行经皮选择性冠状动脉(冠脉)造影。计算baPWV诊断CHD的截尾点、敏感度和特异度,以及baPWV超出年龄和性别预测值的百分数为22.5%时诊断CHD的截尾点及敏感度和特异度;分析颈动脉粥样硬化对CHD诊断的敏感度和特异度;联合二者分析平行试验时对CHD诊断的敏感度和特异度,并对不同CHD亚组进行组间分析。结果:运用ROC曲线求得曲线下面积为0.655,baP-WV超出年龄预测值百分数为22.5%时获得最大准确度,其对CHD诊断的敏感度为0.632,特异度为0.618;颈动脉粥样硬化对CHD诊断的敏感度为0.885,特异度为0.684;联合二者平行试验对CHD诊断的敏感度提高为0.958,特异度降低为0.432。结论:联合baPWV检测和颈动脉彩色超声检查可作为有创冠脉造影检查前的无创筛查手段。
Objective: To investigate the diagnostic value of brachial-ankle pulse wave velocity (baPWV) and carotid atherosclerosis in patients with coronary heart disease (CHD). Methods: A total of 106 patients underwent baPWV and carotid color ultrasound examinations. Percutaneous selective coronary artery (coronary) angiography was performed. To calculate the cut-off point, sensitivity and specificity of baPWV in diagnosis of CHD and the percentage of cut-off point and sensitivity and specificity of CHD when baPWV exceeded 22.5% of age and gender predictive value; To analyze the effect of carotid atherosclerosis on CHD Sensitivity and specificity of diagnosis; the combination of the two analysis of parallel tests for the diagnosis of CHD sensitivity and specificity, and different groups of CHD subgroup analysis. Results: The area under the curve obtained by ROC curve was 0.655. The maximum accuracy was obtained when the baP-WV exceeded the predicted value of age by 22.5%. The sensitivity and specificity of CHP for diagnosis of CHD was 0.632 and 0.618 respectively. Carotid atherosclerosis The diagnostic sensitivity of CHD was 0.885 and the specificity was 0.684. The sensitivity of the combination of the two parallel tests for diagnosis of CHD was 0.958, and the specificity was 0.432. Conclusion: The combined baPWV test and carotid color ultrasound can be used as a noninvasive screening method before invasive coronary angiography.