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目的:探讨冠心病(CHD)患者各动脉段脉搏波传导速度(PWV)的改变及其对CHD的诊断价值。方法:根据冠状动脉造影将218例患者分为CHD组(121例)和非CHD组(97例),分别进行右侧颈-桡动脉(RC-R)、右侧颈-股动脉(RC-F)、右侧股-踝动脉段(RF-A)和相应左侧动脉段(LC-R、LC-F、LF-A)的PWV检查,分析CHD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曲线(ROC)评价不同动脉段PWV诊断CHD的敏感性和特异性。结果:非CHD组及CHD组的RC-FPWV[(7.60±1.59)∶(9.31±1.75)m/s,P<0.01]、LC-FPWV[(7.52±1.50)∶(9.02±1.71)m/s,P<0.01]、RC-RPWV[(8.00±1.27)∶(8.69±1.37)m/s,P<0.01]和LC-RPWV[(8.03±1.2)∶(8.52±1.03)m/s,P<0.01]差异有统计学意义,而RF-A、LF-APWV则差异无统计学意义。进一步应用ROC验证RC-FPWV、LC-FPWV、RC-RPWV和LC-RPWV对CHD的诊断价值,发现RC-FPWV的ROC曲线下面积(AUC)0.818最大,表示其诊断CHD的真实性最好,由ROC曲线特征发现,RC-RPWV的最佳分界点为8.32m/s,此时敏感性达79%,特异性达77%。结论:CHD患者的RC-FPWV、LC-FPWV、RC-RPWV、LC-RPWV均显著增高,RC-FPWV诊断CHD的价值最大,RC-FPWV测定值大于8.32m/s是预测CHD较为敏感的指标。
Objective: To investigate the changes of pulse wave velocity (PWV) and the diagnostic value of CHD in coronary artery disease (CHD) patients. Methods: 218 patients were divided into CHD group (121 cases) and non-CHD group (97 cases) according to coronary angiography. The right carotid-radial artery (RC-R) and right carotid- PWV examination of the right femoral-ankle artery segment (RF-A) and corresponding left arteries segment (LC-R, LC-F, LF-A) were performed to analyze the changes of PWV in patients with CHD; coronary angiography As the gold standard, the receiver operating characteristic curve (ROC) was used to evaluate the sensitivity and specificity of PWV in different arterial segments in the diagnosis of CHD. Results: Compared with control group, RC-FPWV [(7.62 ± 1.50): (9.02 ± 1.71) m / s, (8.03 ± 1.2) vs (8.52 ± 1.03) m / s, P <0.01] and RC-RPWV [(8.00 ± 1.27) vs (8.69 ± 1.37) m / P <0.01]. There was no significant difference between RF-A and LF-APWV. To further verify the diagnostic value of RC-FPWV, LC-FPWV, RC-RPWV and LC-RPWV for CHD by ROC, we found that the area under ROC curve of RC-FPWV was 0.818, which indicated that the diagnosis of CHD was the best, According to the ROC curve characteristics, the best cut-off point of RC-RPWV is 8.32m / s, at this time the sensitivity is 79% and the specificity is 77%. Conclusion: The value of RC-FPWV in diagnosing CHD is the largest, and the value of RC-FPWV greater than 8.32m / s is the index to predict CHD more sensitively.Conclusion: The levels of RC-FPWV, LC-FPWV, RC-RPWV and LC- .