NVDA评分对预测冠状动脉临界病变最小管腔面积价值的研究

Abstract

目的：按照病变血管数量及年龄进行评分（number of vessels diseased and age，简称NVDA危险评分），通过血管内超声（IVUS）测定前降支近段或中段临界病变的最小管腔面积（MLA），分析患者的临床特征，寻找影响管腔面积的相关因素，建立相关因素评分体系预测MLA。<br> 方法：选择符合纳入标准的患者共90例，其中男性58例，女性32例，年龄41~77岁。收集其人口学资料、病史以及实验室检查数据，进行简单线性回归分析，筛选出影响MLA的因素。随后进行多重线性回归模型分析，建立回归方程预测前降支临界病变的MLA，计算相关因素权重，得出相关因素评分体系。<br> 结果： NVDA危险评分≤4分为阴性，推测MLA≥3.0 mm2；评分>4分为阳性，推测MLA<3.0 mm2。NVDA危险评分预测MLA敏感性为83.33%，特异性为75.00%，阴性预测价值90.00%。<br> 结论：NVDA危险评分对于预测冠状动脉临界病变的MLA具有较好的准确性及较高的敏感性和特异性，对于指导冠状动脉介入治疗具有一定价值。

Objective: Based on scores by number of vessels diseased and age (NVDA), the minimum lumen area (MLA) of left anterior descending (LAD) proximal or middle intermediate lesions were examined by intravascular ultrasound (IVUS) to analyze the clinical characteristics, to ifnd the factors affecting lumen area and to establish a scoring system for predicting MLA in relevant patients. <br> Methods: A total of 90 patients were enrolled including 58 male and 32 female with the age of (41-77) years. The demographic information, medical history and laboratory results were studied by simple linear regression analysis to screen relevant factors affecting MLA; multi regression analysis was conducted to establish a regression equation for predicting MLA and to calculate the risk factor coefifcient for obtaining relevant scoring system. <br> Results: NVDA score≤4 was deifned as negative result with speculated MLA≥3.0mm2, while NVDA score>4 was deifned as positive result with speculated MLA<3.0mm2. The sensitivity, speciifcity and negative predictive value of NVDA scoring system for predicting MLA were 83.35%, 75% and 90% respectively. <br> Conclusion: NVDA scoring system had the better accuracy, sensitivity and speciifcity for predicting MLA in coronary artery intermediate lesions, it had certain value for guiding coronary interventional therapy in relevant patients.