本文選題：冠心病 + 股動脈內中膜厚度　； 參考：《石河子大學》2015年碩士論文

【摘要】：目的:1、通過檢測股動脈內中膜厚度(FA-IMT)及踝臂指數(ABI),評價二者和冠心病的相關水平,分析其對冠心病患者冠狀動脈狹窄程度的預測價值。2、討論冠心病的相關危險因素。方法:收集2013年12月至2014年7月在石河子大學醫(yī)學院第一附屬醫(yī)院行冠狀動脈造影患者98例,根據造影結果分為:一支病變組31例,男:22例,女:9例,平均年齡(58±8)歲;兩支病變組27例,男:18例,女:9例,平均年齡(58±10)歲;三支病變組16例,男:11例,女:5例,平均年齡(62±9)歲;健康對照組24例,男:13例,女:11例,平均年齡(57±6)歲。經患者知情同意后納入研究,對入選者均進行術前股動脈血管超聲及ABI測量、病史采集及常規(guī)化驗檢查。分析對照組與不同程度冠脈病變組FA-IMT與ABI差異是否具有統(tǒng)計學意義,并分析FA-IMT、ABI與冠心病的相關性,評價其對冠心病患者冠狀動脈狹窄程度的預測價值,討論冠心病的相關危險因素。結果:1、性別、年齡、腦卒中病史在各組間比較P均0.05,無統(tǒng)計學意義;體重指數、高血壓病史、吸煙史在各組間比較,P均0.05,存在差異,有統(tǒng)計學意義。2、HDL、TC、LP(a)組間比較均無顯著差異,無統(tǒng)計學意義(P均0.05);LDL、TG、Hcy各組間比較,P均0.05,存在差異,有統(tǒng)計學意義。3、FA-IMT在不同病變組間比較,存在顯著差異,有統(tǒng)計學意義(x2=41.35,P0.01),病例組的FA-IMT[單支病變組(0.17±0.07)cm),雙支病變組(0.24±0.07)cm,三支病變組(0.34±0.06)cm]分別明顯高于對照組[(0.15±0.10)cm],P均0.01;ABI在不同病變組間比較,存在顯著差異,有統(tǒng)計學意義(x2=21.90,P0.01)。病例組的ABI[單支病變組(0.98±0.18),雙支病變組(0.86±0.14),三支病變組(0.86±0.13)]分別明顯低于對照組[(1.06±0.17)],P均0.01。4、相關結果分析:FA-IMT對冠狀動脈粥樣硬化的預測:靈敏度為75.7%,特異度為50%,陽性預測值為82.4%,陰性預測值為40%,陽性似然比為1.51,陰性似然比為0.49;ABI對冠狀動脈粥樣硬化的預測:靈敏度為68.9%,特異度為70.8%,陽性預測值為87.9%,陰性預測值為42.5%,陽性似然比為2.36,陰性似然比為0.44。FA-IMT聯合ABI能較好的預測冠狀動脈粥樣硬化程度,有一定的預測價值。5、spearman等級相關分析表明,FA-IMT與冠狀動脈粥樣硬化呈正相關關系,相關系數R=0.649;ABI與冠狀動脈粥樣硬化呈負相關關系,相關系數R=-0.459;FA-IMT與ABI存在負相關關系,相關系數R=-0.606。結論:1、體重指數、高血壓病史、吸煙史、低密度脂蛋白(LDL)升高、甘油三酯(TG)升高、高同型半胱氨酸(HCy)是造成冠狀動脈粥樣硬化的危險因素;2、FA-IMT與ABI可以預測冠心病患者冠狀動脈狹窄程度。3、FA-IMT越厚,提示冠心病冠脈狹窄程度可能越嚴重,ABI越低,提示冠心病冠脈狹窄程度可能越嚴重,二者聯合診斷冠心病效果更佳。
[Abstract]:Objective to evaluate the correlation between internal medial thickness (FA-IMT) and ankle brachial index (ABI) of femoral artery, analyze their predictive value of coronary artery stenosis in patients with coronary artery disease (CHD), and discuss the risk factors of coronary artery disease (CHD) by measuring the medial thickness of femoral artery (FA-IMT) and ankle brachial index (ABI). Methods: from December 2013 to July 2014, 98 patients underwent coronary angiography in the first affiliated Hospital of Shihezi University Medical College. According to the results of coronary angiography, they were divided into one branch group (31 cases), 22 males and 9 females, with an average age of (58 鹵8) years. The mean age was (58 鹵10) years in the two-vessel disease group (n = 18) and in the female group (n = 9), the mean age was (57 鹵6) years in the three-vessel disease group (n = 16, male: 11, female: 5, mean age: 62 鹵9), and healthy control group (n = 24, male: 13, female: 11, mean age: 57 鹵6). After informed consent, the patients were examined with ultrasound and ABI of femoral artery before operation, history collection and routine laboratory examination. To evaluate the predictive value of FA-IMT and ABI in patients with coronary artery disease (CHD), the difference between FA-IMT and ABI was statistically significant, and the correlation between FA-IMT ABI and coronary artery disease (CHD) was also analyzed in order to evaluate the predictive value of FA-IMT and ABI in patients with coronary artery disease. To discuss the related risk factors of coronary heart disease. Results there was no significant difference in body mass index (BMI), hypertension history and smoking history between the two groups (P 0.05, P < 0.05), but there was no significant difference between the two groups (P > 0.05), and there was no significant difference between the two groups in the TCLP (a) group (P > 0.05), and there was no significant difference in body mass index (BMI), hypertension history and smoking history (P < 0.05) between the two groups, and there was no significant difference between the two groups. There was no significant difference (P 0.05) between the two groups (P 0.05), and there was significant difference between the three groups, and there was significant difference between the three groups, and there was significant difference among the different pathological groups (P < 0.05), and there was significant difference between the three groups (P < 0.05). There was significant difference in FA-IMT [(0.17 鹵0.07) cm in the single vessel lesion group and (0.34 鹵0.06) cm in the three vessel lesion group] compared with the control group [(0.15 鹵0.10) cm] (P < 0.01). There was significant difference between the two groups (x221.90P0.01). ABI [single vessel lesion group (0.98 鹵0.18), double vessel lesion group (0.86 鹵0.14), three-vessel lesion group (0.86 鹵0.13)] was significantly lower than that of control group [(1.06 鹵0.17)] P < 0.01.4. The results of correlation analysis showed that the sensitivity, specificity and positive predictive value of 20% FA-IMT in predicting coronary atherosclerosis were 75.7, 50 and 50, respectively. For coronary artery atherosclerosis, the sensitivity is 68.9, the specificity is 70.8, the positive predictive value is 87.9, the negative predictive value is 42.5, the positive likelihood ratio is 2.36, the negative likelihood ratio is 2.36, and the negative likelihood ratio is 0.49. The predictive value is 82.4, the negative predictive value is 40, the positive likelihood ratio is 1.51, the negative likelihood ratio is 0.49, the specificity is 70.8, the positive predictive value is 87.9, the negative predictive value is 42.5, the positive likelihood ratio is 2.36, and the negative likelihood ratio is 2.36. A ratio of 0.44.FA-IMT combined with ABI could better predict the degree of coronary atherosclerosis. The correlation analysis showed that FA-IMT had a positive correlation with coronary atherosclerosis, and the correlation coefficient RG0.649 ABI had a negative correlation with coronary atherosclerosis, and the correlation coefficient R ~ (-0.459) ~ (FA-IMT) was negatively correlated with ABI, and the correlation coefficient was R ~ (-0.606). Conclusions: 1, BMI, hypertension history, smoking history, low density lipoprotein (LDL), triglyceride (TG) were increased. High homocysteine (HCy) is the risk factor of coronary atherosclerosis. 2FA-IMT and ABI can predict the degree of coronary artery stenosis. It is suggested that the severity of coronary artery stenosis may be more serious, and the combined diagnosis of coronary artery disease is more effective.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R541.4

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1 傅煜;FA-IMT與ABI評價冠心病患者冠脈狹窄程度及相關性研究[D];石河子大學;2015年

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本文編號：2058841