原发性高脂血症患者大动脉僵硬度及顺应性调查与分析  

Investigation and Analysis of Arterial Stiffness and Compliance in Patients with Primary Hypercholesterolemia

作　　者：闻静[1] 华琦[1] 谭静[1] 刘荣坤[1] 杨铮[1] 

机构地区：[1]首都医科大学宣武医院心血管内科

出　　处：《首都医科大学学报》2006年第2期218-221,共4页Journal of Capital Medical University

摘　　要：目的探讨高脂血症合并高血压和2型糖尿病时动脉僵硬度和顺应性的变化及影响因素。方法82例原发性高脂血症患者被分为:亚组1:单纯高脂血症组(n=25),亚组2:高脂血症合并高血压组(n=43),亚组3:高脂血症合并高血压同时合并2型糖尿病组(n=14)。另选46例年龄相仿健康人为对照组。测量入选者颈股动脉脉搏波传导速度(pulse wave velocity,PWV),作为反映大动脉僵硬度指标;应用超声技术测定每搏输出量(SV),以每搏输出量除以脉压(SV/PP)所得出的动脉僵硬度指数为动脉顺应性指标。结果病例组与对照组比较,PWV明显增高(P<0.01),SV/PP明显降低(P<0.05);PWV在各亚组之间比较差异均有统计学意义(P<0.05),随合并危险因素的增加,差异加大;SV/PP在亚组3和亚组1之间差异有统计学意义(P<0.05);多元逐步回归分析显示:PWV与收缩压(SBP)、年龄(Age)、空腹血糖(FBS)呈正相关,回归方程为PWV=1.98+0.055(Age)+0.024(SBP)+0.023(FBS);SV/PP与PP、高密度脂蛋白胆固醇(HDL-C)呈负相关,回归方程为SV/PP=5.178-0.020(SBP)-0.016(HDL-C)。结论PWV可作为原发性高脂血症合并高血压与2型糖尿病引起早期血管功能改变的敏感指标之一;SBP、FBS、HDL-C均是与动脉僵硬度增加和顺应性减低密切相关的危险因素。Objective To investigate arterial stiffness and explore the alterations of arterial stiffness and compliance and compliance in patients with primary hypercholesterolemia and the clinical factors which influence these alterations when in combination with hypertension and type 2 diabetes. Methods 82 patients with primary layperclaolesterolemia were divided into three subgroups, isolated hypercholesterolemia group （subgroup 1, n = 25）, complicated with hypertension group （subgroup 2, n= 43）, complicated with hypertension and type 2 diabetes group （subgroup3, n= 14） ; 46 subjects were enrolled as control group （n=46）. Carotid-femoral pulse wave velocity（PWV） was measured by a validated automatic device as an index of arterial stiffness, ratio of stroke volume（SV） measured by ultrasound to pulse pressure（PP） （SV/PP） as an index of total arterial compliance. Results Compared with the control group,PWV in hypercholesterolemia group was increased significantly [（10. 58± 1.55）, （8.96± 1.01）] m/s （P〈0. 05） and SV/PP decreased significantly [ （1.71±0.67）, （2.06±0.73）] mL/mmHg （P〈0.05） ; PWV was different significantly between two subgroups respectively, with the increasing number of risk factors, the differences were augmented, SV/PP also had significant difference between subgroupl and subgroup3 （P〈0. 05）; Analysis of correlation and multiple stepwise regression： PWV was positively correlated with systolic blood pressure （SBP）, age and fasting blood sugar （FBS）, its multiple linear regression equation was： PWV = 1. 98 ＋ 0. 055 （Age） ＋ 0. 024 （SBP） ＋ 0. 023 （FBS） ; SV/PP was negatively correlated with pulse pressure（SBP） and HDL-C, its equation was SV/PP = 5.178 - 0. 020 （SBP） - 0.016 （HDL-C）. Conclusion PWV was increased and SV/PP decreased significantly in hypercholesterolemia patients; With the number of risk factors increasing, such as hypertension and type 2 diabetes, the alterations were augmented; PWV seems

关 键 词：高脂血症 动脉僵硬度 动脉顺应性 

分 类 号：R543.5[医药卫生—心血管疾病]