无创臂踝脉搏波速度的特征及与心血管危险因素的关系
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(华中科技大学同济医学院:1. 附属同济医院综合科,;2. 公共卫生学院, 武汉 430030)

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Features of noninvasive brachial-ankle pulse wave velocity and their relationship with cardiovascular risk factors
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(1. General Department of Tongji Hospital, ;2. School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China)

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    摘要:

    目的 研究分析臂踝脉搏波传导速度(baPWV)的特征以及与心血管危险因素的相关性。方法 入选2013年1月至2015年3月期间在同济医院综合科参加体检并采用OMRON动脉硬化检测仪VP-1000进行baPWV检测者共3781例(包括住院患者226例)。依据baPWV的检测结果分为两组:baPWV<1400 cm/s组(n=2171)和baPWV≥1400 cm/s组(n=1610)。依据合并冠心病危险因素(高血压、血糖异常、血脂异常、肥胖和吸烟史)的个数将226例住院患者分为4组:0项组(n=75)、1项组(n=33)、2项组(n=49)和3~5项组(n=69)。采用OMRON动脉硬化检测仪VP-1000测定baPWV。结果 年龄、性别、心率、收缩压(SBP)、体质量指数(BMI)和平均动脉压(MAP)是影响baPWV的独立危险因素。男性和女性的baPWV均随年龄呈增加趋势,同时,每个年龄阶段的女性baPWV均显著低于同年龄阶段的男性,差异均具有统计学意义(P<0.05)。baPWV与年龄(r=0.66)、SBP(r=0.62)、舒张压(DBP,r=0.26)、MAP(r=0.59)、颈动脉内膜中层厚度(CIMT,r=0.37)、尿酸(UA,r=0.16)、血糖(Glu,r=0.17)和糖化血红蛋白(HbA1c,r=0.19)呈显著正相关(P<0.05),与总胆固醇(TC,r=-0.24)和左心室射血分数(LVEF,r=-0.23)呈显著负相关(P<0.05)。随着合并危险因素数量的增加,年龄和 baPWV均呈显著增长趋势(P<0.01)。baPWV对冠心病诊断具有中等预测价值(曲线下面积为0.718,P<0.05)。结论 baPWV与心血管危险因素密切相关,传统的心血管危险因素数量越多,baPWV值越大,baPWV对冠心病的诊断具有中等预测价值。

    Abstract:

    Objective To investigate the features of brachial-ankle pulse wave velocity (baPWV) and their correlation with cardiovascular risk factors. Methods A total of 3781 patients (including 226 inpatients) taking physical examination in the General Department of Tongji Hospital from January 2013 to March 2015 were recruited in this study. They all underwent baPWV (OMROM arteriosclerosis detector VP-1000, Japan) examination, and then divided into the baPWV <1 400 cm/s group (n=2171) and baPWV ≥1400 cm/s group (n=1610). For the 226 inpatients, they were assigned into 4 groups according to the existences of risk factors for coronary heart diseases (hypertension, pathoglycemia, dyslipidemia, obesity and history of smoking), that is, 0 item group (n=75), 1 item group (n=33), 2 items group (n=49) and 3-5 items group (n=69). Results Age, gender, heart rate, systolic blood pressure (SBP), body mass index (BMI) and mean artery pressure (MAP) were independent influencing factors for baPWV. Though males and females showed similar increasing trend of baPWV level with their aging, the females had significantly lower levels when compared with the males at same age period (P<0.05). The baPWV level was positively correlated with age (r=0.66), SBP (r=0.62), diastolic blood pressure (DBP, r=0.26), MBP (r=0.59), carotid intima-media thickness (CIMT, r=0.37), uric acid (UA, r=0.16), glucose (r=0.17) and glycosylated hemoglobin A1c (r=0.19) (all P<0.05), and negatively correlated with total cholesterol (TC, r=-0.24) and left ventricular ejection fraction (LVEF, r=-0.23) (both P<0.05). With the increase in number of multiple risk factors, the age and baPWV level showed an elevating tendency (P<0.01). baPWV was confirmed to have moderate predictive value for diagnosis of coronary heart diseases, with the area under the curve (AUC) of 0.718 (P<0.05). Conclusion BaPWV is closely associated with the cardiovascular risk factors. The more conventional cardiovascular risk factors, the higher the baPWV level is. baPWV is of moderate predictive value in the diagnosis of coronary heart diseases.

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隗玮,张存泰,吕美霞,刘彧.无创臂踝脉搏波速度的特征及与心血管危险因素的关系[J].中华老年多器官疾病杂志,2017,16(4):274~278

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  • 收稿日期:2016-11-19
  • 最后修改日期:2016-12-23
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  • 在线发布日期: 2017-05-03
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