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目的:研究踝-臂血压指数(ABI)和冠状动脉硬化程度的关系。方法:2008年1月～2008年6月在本院行选择性冠状动脉造影检查的住院患者111例,男性79例,女性32例,年龄56.9±7.8岁。其中经冠状动脉造影证实有冠状动脉病变者81例,冠状动脉正常者30例。患者在术前取平卧位,测量四肢血压后计算踝-臂血压指数,即胫后动脉或足背动脉收缩压与肱动脉收缩压之比,正常值≥1.0。选择性冠状动脉造影(CAG)用Judikin’s法按常规选择投照体位。采用Gensini积分系统,对每支血管病变程度进行定量评定,每例患者冠状动脉病变程度的最终积分为各分支积分之和。结果:冠状动脉正常组(30例)的冠状动脉积分为(0.43±10.85;ABI=1.14±0.21);单支病变组(33例)的冠状动脉积分为(13.54±9.96;ABI=0.95±0.25);双支病变组(30例)的冠状动脉积分为(24.26±11.26;ABI=0.96±0.29);3支病变组(18例)的冠状动脉积分为(39.55±12.36;ABI=0.68±0.35)。冠状动脉正常组和有冠状动脉病变组的ABI有显著统计学差异(P<0.001),冠状动脉单支病变、双支病变组和3支病变组的ABI比较有显著统计学差异(P<0.001),冠状动脉病变越严重ABI越小。冠状动脉造影积分和ABI的相关系数为-0.536(P=0.0001),即冠状动脉造影积分越高,ABI越低,呈负相关。多元Logistic回归提示糖尿病、空腹血糖增高和冠状动脉积分增高是ABI<0.9的预测因素。结论:ABI是预测冠状动脉硬化程度的一种简单可靠的指标。
Objective: To study the relationship between ankle-arm blood pressure index (ABI) and coronary atherosclerosis. Methods: From January 2008 to June 2008, 111 hospitalized patients undergoing elective coronary angiography in our hospital were enrolled. There were 79 males and 32 females, aged 56.9 ± 7.8 years. Among them, 81 cases of coronary artery lesions confirmed by coronary angiography and 30 cases of normal coronary arteries. Patients were supine in the preoperative measurement of limb blood pressure after the calculation of ankle - arm blood pressure index, that is, the posterior tibial artery or dorsalis pedis artery systolic blood pressure and brachial artery ratio, normal ≥ 1.0. Selective coronary angiography (CAG) with Judikin’s method according to the conventional choice to position. The Gensini score system was used to quantitatively assess the degree of vascular lesion. The final score of coronary lesion in each patient was the sum of all the branch points. Results: Coronary artery scores of normal coronary arteries (30 cases) were (0.43 ± 10.85; ABI = 1.14 ± 0.21); coronary arteries of single lesions were (13.54 ± 9.96; ABI = 0.95 ± 0.25 ); Coronary artery score of double-vessel lesion group (30 cases) was (24.26 ± 11.26; ABI = 0.96 ± 0.29); coronary artery score of three lesion group (18 cases) was (39.55 ± 12.36; ABI = 0.68 ± 0.35 ). There was significant difference in ABI between normal coronary artery group and coronary artery disease group (P <0.001). There was significant difference in ABI between coronary artery single vessel disease, double vessel disease group and 3 lesion group (P <0.001) ), The more severe coronary lesion ABI smaller. Coronary angiography score and ABI correlation coefficient -0.536 (P = 0.0001), that coronary angiography score higher, ABI lower, was negatively correlated. Multivariate Logistic regression suggested that diabetes, fasting plasma glucose and coronary artery elevation were the predictors of ABI <0.9. Conclusion: ABI is a simple and reliable predictor of the degree of coronary atherosclerosis.