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[弗兰克征与冠状动脉疾病]

[Frank's sign and coronary disease].

作者信息

Lesbre J P, Castier B, Tribouilloy C, Labeille B, Isorni C

出版信息

Ann Cardiol Angeiol (Paris). 1987 Jan;36(1):37-41.

PMID:3827155
Abstract

The authors study the sensitivity, the specificity and the predicting value of Frank's sign (presence of a groove at the level of the earlobe) on a group of 172 patients undergoing a clinical examination, an EKG at rest and effort, and a selective coronary arteriogram for suspicion of coronary disease. The criteria retained for the diagnosis of coronary disease is the presence of stenosis superior or equal to 75 p. cent in one of the three main coronary vascular trunks. Statistical studies using the CHI 2 test reveal a highly significant association between Frank's sign and coronary disease (p less than 0.001). The sensitivity of Frank's sign reaches 75 p. cent, its specificity 57.5 p. cent and its positive predicting value 80.3 p. cent. The predicting value is a function of the sex: it is a great deal lower in women (50 p. cent) than in men (84.7 p. cent). The prevalence of Frank's sign increases progressively with age: 42 p. cent in the 30-39 age group and 75.8 p. cent in the 60-69 age group. The predicting value remains high however beyond 60 years: predicting value of 77 p. cent. Frank's sign is correlated neither with the gravity of the coronary disease, nor the duration of the angina, nor with any of the risk factors studied here: tobacco, hypercholesterolemia, arterial hypertension, diabetes, obesity. Frank's sign is therefore considered as a marker of the coronary disease, independent of risk factors but frequently associated with them. If its absence does not permit in any way to exclude the diagnosis of coronary disease, its presence corresponds in three quarters of the cases to an established coronary disease within a symptomatic population.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

作者对172例因怀疑患有冠心病而接受临床检查、静息及运动心电图检查和选择性冠状动脉造影的患者,研究了耳垂水平出现沟纹的弗兰克征的敏感性、特异性及预测价值。诊断冠心病的标准是三大主要冠状动脉血管主干之一存在75%及以上的狭窄。使用卡方检验的统计研究显示,弗兰克征与冠心病之间存在高度显著的关联(p值小于0.001)。弗兰克征的敏感性达到75%,特异性为57.5%,阳性预测值为80.3%。预测价值因性别而异:女性(50%)远低于男性(84.7%)。弗兰克征的患病率随年龄逐渐增加:30 - 39岁年龄组为42%,60 - 69岁年龄组为75.8%。然而,60岁以上的预测价值仍然很高:预测价值为77%。弗兰克征与冠心病的严重程度、心绞痛持续时间以及这里研究的任何风险因素(吸烟、高胆固醇血症、动脉高血压、糖尿病、肥胖)均无关联。因此,弗兰克征被视为冠心病的一个标志物,独立于风险因素但常与之相关。如果其不存在绝不能排除冠心病的诊断,那么在有症状人群中,其存在在四分之三的病例中对应已确诊的冠心病。(摘要截选至250词)

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