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目的探讨超声颈动脉局部压力波形反射波点对冠心病及冠状动脉病变程度的评估价值。方法行冠状动脉造影患者158例,冠状动脉未见异常者50例为非冠心病组,有冠状动脉病变患者108例为冠心病组,其中单支血管病变45例(单支病变组),多支血管病变63例(多支病变组),根据颈动脉射频血管压力波波形分析(quality arterial stiffness technique-pulse wave analysis,QAS-PWA)提取反射波幅值(H)、反射波斜率(R)及反射波增强指数(augmentation index,AIX)。分析各参数与冠状动脉病变程度的相关性。结果单支病变组、多支病变组H[(114.415±12.486)、(114.920±13.291)mm Hg]和R(0.513±0.104、0.561±0.111)均明显高于非冠心病组[(106.000±14.000)mm Hg,(0.449±0.119)],差异均有统计学意义(P<0.05),且多支病变组R高于单支病变组(P<0.05);各组AIX比较差异无统计学意义(P>0.05);logistic回归分析显示R对冠心病发生的影响力最大(回归系数β=7.005),Spearman秩相关分析显示R与冠状动脉病变程度呈明显正相关(r=0.532,P=0.000)。结论颈动脉压力波形图中反射波点幅值H与冠心病的发生可能有相关性,反射波点斜率R与冠心病及病变程度呈正相关,波形图反射波点位置随冠心病发生及病变程度加重逐渐前移,对冠心病及病变程度预估有一定价值。
Objective To evaluate the value of local pressure wave reflected by ultrasonic carotid artery on the severity of coronary heart disease and coronary artery disease. Methods 158 cases of coronary angiography patients, no abnormal coronary artery in 50 cases of non-coronary heart disease group, coronary artery disease in 108 cases of coronary heart disease group, including 45 cases of single vessel disease (single disease group), and more Sixty-three patients with multi-vessel disease were included in this study. Amplitude of reflected wave (H) and slope of reflected wave (R) were extracted by QAS-PWA (carotid arterial stiffness technique-pulse wave analysis) And augmentation index (AIX). The correlation between the parameters and the severity of coronary artery disease was analyzed. Results H (114.415 ± 12.486), (114.920 ± 13.291) mm Hg and R (0.513 ± 0.104, 0.561 ± 0.111) were significantly higher in single vessel disease group and multiple vessel disease group than in non coronary artery disease group [(106.000 ± 14.000 ) mmHg, (0.449 ± 0.119)], the differences were statistically significant (P <0.05), and multi-vessel disease group R was higher than the single vessel disease group (P <0.05); no significant difference in each group of AIX (P> 0.05). Logistic regression analysis showed that R had the most significant influence on coronary heart disease (regression coefficient β = 7.005). Spearman rank correlation analysis showed that R had a positive correlation with the degree of coronary artery disease (r = 0.532, P = 0.000 ). Conclusions The amplitude of reflection wave point H in carotid artery pressure waveforms may correlate with the occurrence of coronary heart disease. The slope R of the reflected wave points is positively correlated with the degree of coronary heart disease and pathological changes. The location of reflected wave points of the waveform changes with the incidence and severity of coronary heart disease Increase gradually move forward, coronary heart disease and the degree of lesion has a certain value.