女性代谢综合征患者踝臂指数与全因及心血管病死亡的关系  

The Association Between Ankle-brachial Index and Cardiovascular Disease or All-cause Mortality in Female Patients with Metabolic Syndrome

作　　者：马文林[1] 李觉[2] 郑黎强[2] 罗盈怡[2] 徐远溪[1] 高文根[3] 胡大一[4] 

机构地区：[1]上海同济大学附属同济医院心内科 [2]同济大学医学院流行病学教研室 [3]北京大学人民医院心脏中心,北京100000 [4]同济大学医学院心肺血管中心,上海200065

出　　处：《中华高血压杂志》2007年第11期908-912,共5页Chinese Journal of Hypertension

摘　　要：目的研究踝臂指数(ABI)与女性代谢综合征(MS)患者全因死亡与心血管病(CVD)死亡之间的关系。方法符合国际糖尿病学会(IDF,2005)MS诊断标准的女性MS患者1049例入选。进行ABI的测量及平均13.6月随访。按ABI水平的不同将研究对象分为外周动脉疾病(PAD)组(ABI≤0.9,共259例)和非PAD组(ABI在0.91～1.40之间,共790例)。结果在基线水平,PAD组的年龄、高血压患病率、收缩压水平、糖尿病患病率、吸烟率均高于非PAD组(P<0.05)。PAD组与非PAD组的全因死亡率分别为10.4%和4.4%(P<0.01),CVD死亡率分别为4.6%和1.6%(P<0.01)。ABI最高第4分位(≤0.40)较最低的第1分位(1.00～1.40)全因死亡增加3.7倍(P=0.012),心血管病死亡率虽有增加但无显著性。通过COX回归分析,调整年龄、高血压史、糖尿病史、吸烟等因素后,显示全因死亡和CVD死亡的相对危险仍呈同样趋势。结论低ABI是预测女性MS患者全因死亡的独立性危险因素,女性MS患者早期常规接受ABI检查,积极预防和治疗PAD对提高生存率具有重要价值。Objective To investigate the association between the Ankle-brachial Index（ ABI） and all cause or cardiovascular disease{CVD） mortality in female metabolic syndrome （MS） population. Methods A total of 1049 female MS patients diagnosed based the criterion by international diabetes federation （IDF, 2005） submitted to ABIs and were classified into 2 groups： PAD group（ABI〈0.9, n=259） and non-PAD group （ABI 0.9--1.4, n=790）. All subjects were followed up for average 13.6 months. Results Significant difference in baseline characteristics, age, systolic blood pressure （SBP）, diabetes mellitus morbidity, smoking history was found between PAD and non-PAD patients （P〈0.05 or P〈0.01 ）. During the followed up period, all-cause mortality in PAD patients and non-PAD patients was 10.4% vs 4.4% （ P〈0.01 ） ; CVD mortality were 4.6%vs 1.6%（ P〈 0.01 ）. Mortality decreased progressively while the ABI increased from 0.4 to 1.4. COX regression analysis showed relative hazard ratio （ RR） of all cause mortality and CVD mortality in highest quartile was 3.69 comparing the lowest quartile （P=0. 012）. Conclusion In female MS patients, low ABI is an independent predictive （actor for all-cause mortality. Elderly female MS with low ABI were associated with a poor prognosis. Our results suggest that female MS should receive repeated measurements of ABI as early as possible to prevent the occurrence and development of PAD.

关 键 词：踝臂指数 心血管病死亡 全因死亡 代谢综合征 女性 

分 类 号：R589[医药卫生—内分泌]