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目的研究踝臂指数(ABI)和冠状动脉硬化程度及预后的关系。方法选择2003年1月至6月在黑龙江省大庆市第一人民医院行选择性冠状动脉造影检查的住院患者111例,经冠状动脉造影证实有冠状动脉病变81例,冠状动脉正常30例。测量四肢血压后计算ABI。选择性冠状动脉造影(CAG),采用Gensini积分系统,对每支血管病变程度进行定量评定。对患者进行4年门诊随访。结果冠状动脉正常组(30例)的冠状动脉积分为0.43±10.85,ABI为1.14±0.21;单支病变组(33例)的冠状动脉积分为13.54±9.96,ABI为0.95±0.25;双支病变组(30例)的冠状动脉积分为24.26±11.26,ABI为0.96±0.29;三支病变组(18例)的冠状动脉积分为39.55±12.36,ABI为0.68±0.35。冠状动脉正常组和有冠状动脉病变组的ABI差异有显著性意义(P<0.01)。多元Logistic回归提示糖尿病病史增加、空腹血糖增高和冠状动脉积分增高与ABI呈负相关关系。ABI≥0.9组随访中有2例死亡,ABI<0.9组中有6例死亡(P=0.00367),ABI<0.9是冠心病死亡的预测因素。结论ABI是预测冠状动脉硬化程度和冠心病死亡的一种简单可靠的指标。
Objective To study the relationship between ankle brachial index (ABI) and coronary atherosclerosis and prognosis. Methods One hundred and eleven hospitalized patients undergoing selective coronary angiography at First People’s Hospital of Daqing City in Heilongjiang Province from January 2003 to June 2003 were enrolled in this study. Twenty-one coronary artery lesions and 30 normal coronary arteries were confirmed by coronary angiography. ABI was measured after measuring blood pressure in limbs. Selective coronary angiography (CAG), the use of Gensini integral system, quantitative assessment of the degree of each vascular lesions. Patients were followed up for 4 years. Results The coronary artery score of normal coronary artery group (30 cases) was 0.43 ± 10.85 and ABI was 1.14 ± 0.21. The coronary artery score of single vessel lesion group (33 cases) was 13.54 ± 9.96 and ABI was 0.95 ± 0.25. The coronary artery score of group A (30 cases) was 24.26 ± 11.26 and ABI was 0.96 ± 0.29. Coronary artery score of the three lesions group (39 cases) was 39.55 ± 12.36 and ABI was 0.68 ± 0.35. There was significant difference in ABI between normal coronary artery group and coronary artery lesion group (P <0.01). Multivariate logistic regression showed that the history of diabetes increased, fasting blood glucose and coronary artery integral increased and ABI was negatively correlated. There were 2 deaths in ABI ≥ 0.9 group, 6 deaths in ABI <0.9 group (P = 0.00367), ABI <0.9 was the predictor of coronary heart disease death. Conclusion ABI is a simple and reliable predictor of the degree of coronary atherosclerosis and death of coronary heart disease.