女性多重动脉硬化患者踝臂指数与全因死亡和心血管疾病死亡关系的群组研究  

Relationship between ankle-brachial index and all cause mortality and cardiovascular disease mortality in female patients with atherosclerotic risk factors

作　　者：李觉[1] 李宪凯[1] 罗盈怡[1] 邢燕[1] 郑黎强[1] 刘浩[1] 余金明[1] 胡大一[1] 

机构地区：[1]同济大学心肺血管中心,上海200092

出　　处：《中国实用内科杂志》2007年第9期662-665,共4页Chinese Journal of Practical Internal Medicine

摘　　要：目的研究具有动脉硬化危险因素的女性住院患者的踝臂指数（ankle—braehial index，ABI）与全因死亡和心血管疾病（CVD）死亡的关系，方法收集2004年7月至2005年1月上海和北京多中心连续内科住院患者中具有2个或2个以上动脉硬化危险因素的女性患者1744例，年龄35～95岁，进行基线特征调查并平均随访（11.8±0．4）个月。结果ABI≤0．90诊断外周动脉疾病（PAD）者492例，ABI为0.91～1.40者1252例为非PAD，PAD组的年龄、高血压史、收缩压、血脂紊乱史、甘油三酯、高密度脂蛋白胆固醇、糖尿病史、空腹血糖、吸烟史、全因病死率和CVD病死率均高于非PAD组，差异有显著性意义。全因病死率和CVD病死率分别在重度PAD组、轻度至中度PAD组、临界组和正常对照组中的差异有显著性意义（P〈0．05）。采用Cox回归分析后，重度PAD组全因死亡的RR为4．429（95％CI：2.144～9.149），CVI）死亡的RR为6.215（95％CI：1.831～21.099），轻至中度PAD组CVD死亡的RR为2．024（95％CI：1.117～3.664）。PAD组的存活率显著低于非PAD组（P〈0.001）。结论低踝臂指数是具有多重动脉硬化危险因素的女性患者全因死亡和CVD死亡的独立危险因素，尤其是CVD死亡，ABI越低，CVD死亡危险性越高。To study the relationship between ankle-brachial index and all cause mortality and cardiovascular disease mortality in female Chinese patients with atherosclerotic risk factors. Methods A total of 1,744 female patients with no less than two atherosclerotic risk factors were enrolled from several hospitals in Shanghai and Beijing. Baseline ex-ams were measured. All the participants were followed up 13 months. Results The patients with PAD were significantly older than those without PAD [ （72.42±9.158） years vs （65.89±10.366） years, P 〈0.001]. The patients with PAD were significantly more likely to have hypertension, diabetes mellitus,dyslipidemia, and smoking habit. All-cause and CVD mortality were higher in patients with PAD than those without PAD. Adjusted other risk factors, the patients with ABI≤0. 4 were more than 4.429 times likely to die than those with 1.0〈ABI≤1.4 （ 95% CI：2.144～9.149） ;the patients with ABI≤0.4 were more than 6.215 times likely to die of CVD than those with 1.0〈 ABI≤1.4 （ 95% CI： 1.831～21.099） ;and 2.531（95% CI： 1.103～5.805） for patients with 0.41〈 ABI ≤0.90. Conclusion Low ABI is independ-ently associated with the high risks of all-cause and CVD mortality in Chinese hospitalized female patients with atheroscle-rotic risk factors.

关 键 词：动脉硬化 踝臂指数 外周动脉疾病 病死率 危险因素 

分 类 号：R5[医药卫生—内科学]