摘要
目的:探讨冠状动脉粥样硬化性心脏病(冠心病)患者各动脉段脉搏波传导速度的改变及其对冠心病的诊断价值。方法:根据冠状动脉造影结果将218例患者分为冠心病组(121例)和非冠心病组(97例),分别进行右侧颈-桡(RC-R)、右侧颈-股(RC-F)、右侧股-踝(RF-A)动脉段和相应左侧动脉段(LC-R、LC-F、LF-A)的脉搏波传导速度(pulsewavevelocity,PWV)检查,分析冠心病患者的PWV变化特征;以冠状动脉造影为金标准,应用受试者工作特征(ROC)曲线评价不同动脉段PWV诊断冠心病的敏感度和特异度。结果:非冠心病组及冠心病组的RC-FPWV(7.60±1.59和9.31±1.75P<0.01)、LC-FPWV(7.52±1.50和9.02±1.71P<0.01)、RC-RPWV(8.00±1.27和8.69±1.37P<0.01)和LC-RPWV(8.03±1.2和8.52±1.03P<0.01)差别有显著性,而RF-APWV、LF-APWV则差别无显著性。进一步应用ROC曲线验证RC-FPWV、LC-FPWV、RC-RPWV和LC-RPWV对冠心病的诊断价值,发现RC-FPWV的ROC曲线下面积(AUCROC=0.818)最大,表示其诊断冠心病的有效率最好,由ROC曲线特征发现,RC-RPWV的最佳分界点为8.32m/s,此时敏感度达79%,特异度达77%。结论:冠心病患者的RC-FPWV、LC-FPWV、RC-RPWV、LC-RPWV均显著高于非冠心病组,RC-FPWV诊断冠心病的价值最大,RC-FPWV测定值大于8.32m/s是预测冠心病较为敏感的指标。
Objective To evaluate the value of pulse wave velocity （PWV） using receiver operating characteristics （ROC） curve in the diagnosis of coronary heart disease （CHD）. Methods According to the results from coronary angiography, 218 patients were divided into CHD group （n=121） and Non-CHD group （n=97）. All the patients received PWV test. The efficacy of PWV of each artery segment in the diagnosis of CHD was evaluated by ROC curve. The sensitivity and specificity was calculated with the golden diagnostic standard of CHD. Results The PWVs of the fight carotid to the femoral artery（RC-F） and the left carotid to the femoral artery（LC-F）, the fight carotid to radial artery（RC-R and the left carotid to radial artery （LC-R in the CHD group were significantly higher than those in the non-CHD group （9.31±1.75 vs 7.60± 1.59 P〈0.01, 9.02±1.71 vs 7.52±1.50 P〈0.01, 8.69±1.37 vs 8.00±1.27 P〈0.01, and 8.52±1.03 vs 8.03±1.2 P〈0.01, respectively）; however, the PWVs of the fight femoral to the ankle artery （RF-A） and the left femoral to the ankle artery （LF-A） were similar in the two groups. The area under curve of each ROC （AUC^ROC） was used to further evaluate the diagnostic efficacy of RC-F PWV, LC-F PWV, RC-R PWV and LC-R PWV. The results showed that AUC^ROC of RC-F PWV was the biggest （AUC^ROC=0.818）, and at peak point of its ROC curve of the PWV was 8.32 m/s, which predicted the presence of CHD with the sensitivity of 79% and the specificity of 77%. Conclusions The PWVs of RC-F, RC-F, LC-F and LC-R are significantly higher in the CHD group than those in the non-CHD group, among which PWV of RC-F is the most accurate in the diagnosis of CHD. PWV〉8.32 ntis of RC-F is a valuable predictor of CHD.
出处
《诊断学理论与实践》
2006年第4期332-335,共4页
Journal of Diagnostics Concepts & Practice
