男性高血压患者踝臂指数与全因和心血管病死亡关系的群组研究  

The relationship of ankle brachial index to all-cause and cardiovascular disease mortality in Chinese male patients with hypertension

作　　者：郭薇薇[1] 李觉[1] 余金明[1] 罗盈怡[1] 刘浩[1] 郑黎强[1] 布艾加尔.哈斯木[1] 李宪凯[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：《中华预防医学杂志》2007年第6期487-491,共5页Chinese Journal of Preventive Medicine

摘　　要：目的研究男性高血压患者外周动脉疾病(PAD)的危险因素及踝臂指数(ABI)与全因和心血管病(CVD)死亡的关系。方法研究对象来自2004年7月至2005年1月北京及上海地区8所医院有完整 ABI 基线资料的男性高血压患者,将 ABI≤0.9作为诊断 PAD 的指标,于2005年11月至2006年1月对其进行随访调查。结果 1606例男性高血压患者中,PAD 组406(25.3%)例,非PAD 组1200(74.7%)例,年龄、血总胆固醇(TC)、糖尿病史、吸烟史和2级高血压是 PAD 可能的危险因素,在平均(12.87±2.94)个月的随访中,153例死亡,其中62例为 CVD 死亡。经 Cox 回归分析,PAD 患者发生全因及 CVD 死亡的相对危险度分别为1.728(1.223～2.441)和2.388(1.409～4.046)。PAD 组的生存率显著低于非 PAD 组。随 ABI 水平的降低发生死亡及 CVD 死亡的危险增加。结论低 ABI 是男性高血压患者死亡和 CVD 死亡的独立性危险因素,在男性高血压人群中运用无创性 ABI 测定对死亡及 CVD 死亡具有预测价值。Objective To evaluate the risk factors for peripheral arterial disease （PAD） and the relationship of low ankle brachial index （ABI） to all-cause and cardiovascular disease （CVD） mortality in Chinese male patients with hypertension. Methods The data of 1606 male participants with hypertension from the eight hospitals in Beijing and Shanghai were analyzed. ABI was ascertained at baseline by measuring the systolic pressures on bilateral brachial and fibial arteries. ABI ≤0. 9 was used as the diagnostic criteria for PAD identification. The follow-up survey was conducted from November 2005 to January 2006. Results Of 1606 male participants with hypertension at baseline, 406 （25.3 % ）were in low- ABI group and 1200 （74. 7% ） were in normal-ABI group. Older age, TC, history of diabetes, history of smoking and 2-grade hypertension were associated with low ABI in male patients with hypertension. During the（12. 87 ±2. 94）months follow-up, there were 153 deaths. Of which, 62 were attributable to CVD. Low ABI was associated with adjusted all-cause and CVD mortality risk of 1. 728 （ 1. 223 - 2. 441 ） and 2. 388 （ 1. 409 - 4. 046 ） respectively in Cox regression models. Rate of survival for the low-ABI group was significantly worse than for the normal-ABI group. The risk of all-cause and CVD mortality was increased with the decline of ABI. Conclusion Low ABI is independently associated with the high risks of all-cause and CVD mortality in Chinese male patients with hypertension. The utility of ABI as a tool for predicting mortality in the patients with hypertension should be popularized.

关 键 词：流行病学 死亡率 踝臂指数 外周动脉疾病 高血压 全因和心血管病 

分 类 号：R544.1[医药卫生—心血管疾病]