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目的:探讨颈动脉斑块及主动脉脉压(PP)与冠状动脉病变严重程度的相关性和预测价值。方法:将276例均行冠脉造影、主动脉压测量、颈动脉超声的患者资料回顾性分析,根据有无颈动脉斑块和PP水平≥或<65 mm-Hg分为4组:无颈动脉斑块+PP<65 mmHg组,无颈动脉斑块+PP≥65 mmHg组,颈动脉斑块+PP<65 mmHg组和颈动脉斑块+PP≥65 mmHg组,进行比较分析。结果:4组间年龄、血压、血脂有显著差异(P<0.05,P<0.01);多元线性逐步回归分析显示:年龄、PP、颈动脉斑块与冠脉积分正相关;颈动脉斑块和PP增大预测冠脉病变严重程度的敏感性为81%vs.77%、特异性为93%vs.91%、阳性预测值为57%vs.51%和阴性预测值为98%vs.97%,二者结合可提高敏感性(90%)和阳性预测值(77%,均P<0.05)。结论:颈动脉斑块联合PP可更好地预测冠脉病变严重程度。
Objective: To investigate the correlation and predictive value of carotid artery plaque and aortic pulse pressure (PP) with the severity of coronary artery disease. Methods: The data of 276 patients undergoing coronary angiography, aortic pressure measurement and carotid artery ultrasound were retrospectively analyzed. According to the presence or absence of carotid artery plaque and PP levels ≥ or <65 mm-Hg, the patients were divided into 4 groups: Atherosclerotic plaque + PP <65 mmHg group, no carotid artery plaque + PP≥65 mmHg group, carotid plaque + PP <65 mmHg group and carotid plaque + PP≥65 mmHg group were compared and analyzed. Results: There were significant differences in age, blood pressure and blood lipid between the four groups (P <0.05, P <0.01). Multivariate linear stepwise regression analysis showed that age, PP, carotid plaque were positively correlated with coronary score, PP increased the sensitivity of predicting the severity of coronary lesions was 81% vs 77%, specificity 93% vs 91%, positive predictive value 57% vs 51% and negative predictive value 98% vs. 97 %, The combination of the two can improve the sensitivity (90%) and the positive predictive value (77%, both P <0.05). Conclusion: Carotid plaque combined with PP can better predict the severity of coronary lesions.