摘要
目的:评价高血压患者脉压/踝臂指数比值对冠心病的预测价值,为冠心病的早期诊断和预防提供依据。方法:选择120例高血压患者,根据冠脉造影及临床表现分为冠心病组和非冠心病组。比较2组间的24h平均收缩压、平均舒张压、脉压、脉压/踝臂指数比值及冠心病高危因素;用Logistic回归分析上述因素对冠心病的预测价值,用受试者工作特征曲线(ROC曲线)分析脉压/踝臂指数比值预测冠心病的截断值、特异性、敏感性、阳性预测值和阴性预测值。结果:冠心病组患者和非冠心病组患者之间比较,收缩压、舒张压、脉压、踝臂指数等均未显现出统计学差异。总胆固醇、低密度脂蛋白、吸烟、糖尿病等差异具有统计学意义。脉压和踝臂指数分别与脉压/踝臂指数比值存在相关性。脉压/踝臂指数比值在两组之间的差异有统计学意义(P=0.001),相关分析和回归分析显示脉压/踝臂指数比值对冠心病有独立的预测价值。通过对脉压/踝臂指数比值的ROC曲线分析发现,当脉压/踝臂指数比值≥55.9时,预测高血压患者合并冠心病的敏感度为65.9%,特异度为32.9%,阳性预测值为53.7%;阴性预测值为77.3%。结论:使用脉压/踝臂指数比值预测高血压患者合并冠心病的敏感性高于单纯使用踝臂指数或脉压。对于高血压患者合并冠心病的早期识别,脉压/踝臂指数可能有一定的临床价值。
Objective：To provide basis for the early diagnosis and prevention of coronary atherosclerotic heart disease （CHD） by calculating the ratio of pulse pressure （PP）/ankle-brachial index（ABI）.Methods：Total 120 cases of hypertension patients were randomly selected.They were divided into two groups according to coronary angiography（CAG）and clinical manifestation,group A：CHD group,group B：non-CHD group.The average of 24-hour systolic blood pressure（SBP）,diastolic blood pressure（DBP）,PP,PP/ABI and some other risk factors of CHD between the two groups were compared;the predictive value of CHD was judged by Logistics regression analysis with the above factors,and the ratio of PP/ABI was analyzed;the cutoff value,specificity,sensitivity,positive predictive value and negative predictive value of in diagnosing CHD were predicted with the method of receiver operator characteristic（ROC） analysis.Results：There were no significant differences in SBP,DBP,PP and ABI between the two groups,but there existed great differences in total cholesterol,low density lipoprotein,diabetes and so on.PP and ABI correlate with PP/ABI.The ratio of PP/ABI differed between the two groups,which had statistical significance （P=0.001）.Correlation and regression analysis indicated that there was independent predictive value of the PP/ABI ratio in the diagnosis of CHD.ROC analysis indicated that when the cut point equalled to or above 55.9,the sensitivity of predicting hypertensive patients with CHD is 65.9%,the specificity is 32.9%,the positive predictive value is 53.7% and the negative predictive value is 77.3%.Conclusion：In the diagnosis of hypertension patients with CHD,the ratio of PP/ABI is more sensitive than ABI or PP.The ratio of PP/ABI has clinical value in the early identification of hypertension patients with CHD.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2010年第10期1417-1422,共6页
Journal of Nanjing Medical University(Natural Sciences)
关键词
脉压
踝臂指数
冠状动脉硬化性心脏病
pulse pressure； ankle-brachial index； coronary atherosclerotic heart disease；
