【摘要】 目的探讨眼底动脉硬化程度、肱-踝脉搏波传导速度(BaPwv)及踝臂指数(ABI)与冠状动脉造影(CAG)结果的相关性,了解三者在预测冠心病方面的价值。方法将472例行CAG患者分为4组。分别为为冠状动脉正常组(66例)、单支病变组(138例)、双支病变组(174例)和左主干或多支病变组(94例)。对所有患者进行眼底照相、BaPwv及ABI检测,同时收集病史、心电图、彩色多普勒超声心动图及生化检查等指标,评价眼底动脉硬化程度、BaPwv及ABI对冠状动脉病变程度的预测意义。结果眼底动脉无硬化的病例中有86%的患者冠状动脉正常;眼底动脉硬化在Ⅱ级以上的病例中有71%的患者冠脉病变在双支以上。单支病变组、双支病变组、左主干或多支病变组患者BaPwv较冠脉正常组显著增高(P<0.05)。BaPwv在单支病变组[(11.53±1.96)m/s]、双支病变组[(12.45±1.23)m/s]、左主干或多支病变组[(14.20±3.24)m/s]间差异有显著统计学意义(P<0.05)综合眼底动脉硬化,BaPwv,ABI及其他危险因素后,发现眼底动脉硬化Ⅱ级以上[OR=11.82,95%CI(7.65～14.91),P<0.01]及BaPwv>14m/s[OR=10.02,95%CI(5.85～12.14),P<0.01]是冠脉多支病变的强有力预测因子。结论眼底动脉硬化及BaPwv均可反应冠脉病变的支数;眼底动脉硬化Ⅱ级以上及BaPwv>14m/s是预测冠状动脉病变程度的早期指标,是冠脉左主干或多支病变的强有力预测因子。更多还原

【Abstract】 Objective To evaluate the value of ocular fundus atherosclerosis(OFA),brachial-ankle pulse wave velocity(BaPwv) and ankle arm pressure index(ABI) in predicting the extent of coronary artery lesions with coronary angiography(CAG) as gold standard.Methods A total of 472 patients were divided into four groups according to the CAG result:normal group(66 cases), single vessel lesion group(138 cases),double vessels lesion group(174 cases) and multiple vessels or left main lesion group(94 cases). All patients underwent OFA examination.BaPwv and ABI detection.Additionally,the data on medical history,electrocardiogram, color Doppllr cardiograph and serum factors were collected.Results In patients without ocular fundus atherosclerosis,86%cases had normal coronary artery.In patients with degreeⅡocular fundus atherosclerosis,71%cases had double vessels lesion.Single vessel lesion group,double vessels lesion group and multiple vessels or left main lesion group had higher BaPwv value than normal group(P<0.05).There was significant difference in BaPwv value between the single vessel lesion[(11.53±1.96) m/s],double vessels lesion[(12.45±1.23) m/s]or multiple vessels lesion group[(14.20±3.24) m/s,P<0.05].DegreeⅡocular fundus atherosclerosis and BaPwv>14 m/s were powerful predictive factors for multiple vessels lesion[OR=11.82,95%CI 7.65-14.91;OR=10.02.95%CI 5.85-12.14,P<0.01],Conclusion Ocular fundus atherosclerosis and BaPwv can mirror the extent of coronary artery lesions. DegreeⅡocular fundus atherosclerosis and BaPwv>14 m/s are powerful predictive factors for multiple vessels lesion.更多还原