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題名 | The Validity of Brachial-ankle Pulse Wave Velocity in Predicting Coronary Artery Disease=臂踝脈波傳遞速度在預測冠狀動脈疾病的效果 |
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作者 | 蘇河名; 李坤泰; 朱志生; 蔡智禮; 李明義; 賴秀美; 許勝雄; 賴文德; | 書刊名 | Acta Cardiologica Sinica |
卷期 | 19:4 2003.12[民92.12] |
頁次 | 頁237-242 |
分類號 | 415.3161 |
關鍵詞 | 臂踝脈波傳遞速度; 冠狀動脈疾病; 冠狀動脈攝影; Brachial-ankle pulse wave velocity; Coronary artery disease; Coronary angiography; |
語文 | 英文(English) |
中文摘要 | 背景:臂踝脈波傳遞速度是一個簡單且非侵襲的診斷工具,且有報告指出它可當作動脈硬化的一個指標。但是這種臂踝脈波傳遞速是否可以正確地預測冠狀動脈疾病尚屬未知。方法與材料:我們回溯地從門診收集了120位做過心導管檢查的病人。每位人均接受臂踝脈波遞速度的檢查。若測出來的值比參考值要高的話,我們視為陽性;否則為陰性。我們據此來計算預測冠狀動脈疾病的敏感度、特異性、陽性和陰性預測值。另外我們也計算,預測一條、二條和三條冠狀動脈病變的敏感度。最後,我們分析冠狀動脈疾病的病人,其臂踝波傳遞速和其他臨床相關因子的關係。結果:在120位病人當中,有83位病人有冠狀動脈病變(定義為至少50%內徑狹窄)。臂踝脈波傳遞速度在預測冠狀動脈疾病的敏感度、特異性、陽性和陰性預測值分別為62%、29%、66%和26%:其在預測一條、二條三條冠狀動脈病變的敏感度分別為57%、55%、和73%。在多變數分析後,我們發現冠狀動脈病變的病人,其臂踝脈波傳遞速度的高低和病人的年紀、血壓的高低有顯著的相關。結論:雖然臂踝脈波傳遞速度是一種簡單且非侵襲性的方法,但是應用在服用高血壓藥物的病人,其預測冠狀動脈病變的敏感度和特異性僅為62%和29%。為了得到更準確的敏感度和特異性,進一步的大型研究(以無服藥病史、無多種病變的病人為研究對象)是須要去做的。 |
英文摘要 | Background: Brachial-ankle pulse wave velocity (baPWV) is a simple and non-invasive diagnostic tool and has been reported to be an indicator of arterial stiffness. However, it is still unclear whether PWV can accurately predict the diagnosis of coronary artery disease (CAD). Materials and Methods: We retrospectively included 120 patients from our OPD, who had ever received coronary angiography examination. BaPWV was measured in each subject. If the measuring baPWV was greater than the normal reference value (provided by Colin Corporation), the result was defined as positive; otherwise, it was defined as negative. We calculated the sensitivity, specificity and positive & negative predictive value in predicting CAD in all subjects. We also calculated the sensitivity in predicting one-vessel, two-vessel and three-vessel CAD. Finally, we analyzed the relationship between baPWV and other associated variables in patients with CAD. Results: Coronary artery disease defined as at least 50% diameter narrowing of a major coronary artery was present in 83/120 (69%) patients. The sensitivity, positive and negative predictive value of baPWV in predicting CAD in all patients were 62% (52/83), 29% (11/37), 66% (52/78) and 26% (11/42), respectively. The sensitivity in predicting one-vessel, two-vessel and three-vessel CAD were 57%(15/26), 55% (15/27), and 73% (22/30), respectively. After multiple linear regression analysis, age and systolic blood pressure are significantly correlated with the value of baPWV in patients with CAD. Conclusion: Although baPWV measurement is a simple and non-invasive method, the sensitivity and specificity of baPWV in predicting CAD were only 62% and 29% in patients under antihypertensive and antianginal drug treatment. Further large-scale studies which enrolled patients without medication and other associated diseases are necessary to define the more accurate sensitivity and specificity of baPWV in predicting CAD. |
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