| Objective : To investigate the correlation between carotid intima media thickness(CCA-IMT),ankle-brachial index(ABI)and Gensini score of coronary artery lesions in coronary atherosclerotic heart disease(CHD),and to clarify the value of IMT and ABI in the diagnosis of CHD and the evaluation of severity of CHD.Risk factors associated with the disease.Methods:274 patients with suspected coronary atherosclerotic heart disease(CHD)who underwent coronary angiography in our hospital from February 2017 to March 2019 were selected as the study subjects.According to the results of coronary angiography,all patients were divided into the CHD group(n=227)and nonCHD group(n=47).The degree of coronary artery stenosis was evaluated by Gensini scoring system in all patients.According to the score,the patients were divided into group A(Gensini score = 0,n = 37),group B(0 <Gensini score < 40,n = 85),group C(40 < Gensini score < 80,n = 70)and group D(Gensini score > 80,n = 82).General data of all patients including name,sex,age,history of hypertension,history of diabetes mellitus and smoking were collected,height and weight were measured,body mass index(BMI)was calculated,24-hour ambulatory blood pressure monitoring was performed to record mean diastolic blood pressure(DBP)and systolic blood pressure(SBP),and relevant laboratory indicators including total blood cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C);carotid IMT was measured by Philips IU22 color Doppler ultrasound diagnostic instrument,and ABI was measured and calculated by Nicolet’s 5MHz Dopplerultrasound detector.The above indexes were compared between coronary heart disease group and non-coronary heart disease group,and IMT and ABI of different Gensini score groups were compared.The data of this study were analyzed by SPSS23.0 statistical software package,and the correlation between risk factors of coronary heart disease,IMT,ABI and Gensini score of coronary heart disease was analyzed by multivariate logistic regression analysis.Result:(1)There was no significant difference in SBP and DBP between CHD group and non-CHD group(P > 0.05).The age and male patients in CHD group were significantly higher than those in non-CHD group.The proportion of hypertension patients,diabetes patients and smokers were also significantly higher than those in non-CHD group(P < 0.05);BMI,FPG,TC,TG,LDL-C in CHD group were significantly higher than those in non-CHD group(P < 0.05).Compared with non-coronary heart disease group,HDL-C was significantly lower than non-coronary heart disease group(P < 0.05),Gensini score of coronary heart disease group was significantly lower than non-coronary heart disease group,IMT was significantly higher than non-coronary heart disease group,ABI was significantly lower than non-coronary heart disease group,the difference was statistically significant(P < 0.05).(2)There were significant differences in age,BMI,male patients,diabetes,smoking,hypertension,TG,HDL-C,Gensini scores,TC,LDL-C,carotid IMT and ABI among the groups with different Gensini scores(P < 0.05).There were no significant differences in SBP and DBP among the different groups(P > 0.05).(3)Because Gensini score of coronary artery was non-normal distribution,Spearman correlation analysis shows that age,male,diabetes,hypertension,smoking,LDL-C,IMT and Gensini score were significantly positively correlated.(r=0.192,0.188,0.221,0.059,0.195,0.089,0.220,P=0.000,0.000,0.000,0.011,0.000,0.001,0.000)HDL-C and ABI were negatively correlated with Gensini scores.(r=-0.063,P=0.004).With age,male,diabetes,hypertension,smoking,LDL-C,IMT,HDL-C and ABI as independent variables and coronary Gensini integral as dependent variable,multiple linear regression analysis was carried out.Age,diabetes mellitus and IMT were the independent influencing factors of Gensini integral(all P < 0.05).The established multiple regression equation was y(Gensini integral)= 16.198 + 0.612 x diabetes(year)+ 0.602 x IMT(mm).(4)Multivariate logistic regression analysis showed that age,sex,hypertension,smoking,diabetes mellitus,LDL-C,IMT,HDL-C and ABI were independent risk factors for coronary heart disease after correction for confounding factors(OR=1.052,2.038,1.910,1.063,1.213,6.416,6.011,5.251,1.925;95%CI1.017~1.210,1.311~6.217,0.612~6.073,1.021~1.114,1.029~1.365,1.852~22.631,2.519~15.432,1.560~18.297,1.801~8.762),Age,male,history of hypertension,diabetes,smoking,elevated and increased LDL-C and IMT,and decreased HDL-C and ABI were independent risk factors for coronary heart disease(P < 0.05).Conclusion: The risk factors of CHD are age,male,hypertension and diabetes mellitus.Smoking,high LDL-C,high IMT,low HDL-C,Gensini score was positively correlated with male,diabetes mellitus,smoking,FPG,TG,and negatively correlated with HDL-C.Gensini score was positively correlated with IMT and negatively correlated with ABI.These risk factors of coronary heart disease and IMT,ABI were all correlated with the degree of coronary artery stenosis to a certain extent,especially the degree of coronary artery stenosis.It is suggested that the detection of IMT and ABI can assist clinicians in assessing the severity of coronary artery lesions in patients with related risk factors,and provide evidence for early diagnosis,prevention and clinical intervention. |
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