高血压患者靶器官损害与踝臂指数异常的关系  

The association of target organ damage with abnormal ankle brachial index in hypertensive patients

作　　者：毛勇[1] 余金明[1] 张芬[1] 战义强[1] 胡大一[2] 姜庆五[1] 

机构地区：[1]复旦大学公共卫生学院临床流行病研究中心,公共卫生安全教育部重点实验室,上海200032 [2]北京大学人民医院心脏中心

出　　处：《中华内科杂志》2012年第2期127-130,共4页Chinese Journal of Internal Medicine

摘　　要：目的 分析高危高血压患者靶器官损害与踝臂指数（ABI）异常的关系.方法 2008年12月至2009年5月横断面研究我国18个研究中心入选的2674例＞40岁无冠心病、卒中/短暂性脑缺血发作或动脉硬化临床症状的原发性高血压患者ABI异常（ABI ＜0.90）情况,并收集病史、体检和实验室检查资料.结果 有效对象共2615例.兼有左心室肥厚、动脉壁增厚和血肌酐轻度升高的高危高血压患者ABI异常率均高于无相应靶器官损害者（P＜0.05）；与正常组相比,ABI异常组血肌酐平均值较大（P＜0.01）.校正一定因素（研究中心、人口学因素、心血管病危险度和心血管病危险因素）后,拟合靶器官损害与ABI异常关系的非条件logistic回归模型表明,动脉壁增厚（OR2.416,95％CI 1.395～4.183,P=0.0016）和血肌酐轻度升高（OR 3.377,95％ CI1.267 ～8.997,P=0.0149）与ABI异常之间有正相关关系,而左心室肥厚（OR 0.988,95％ CI0.576～1.695,P=0.9664）和微量白蛋白尿（OR1.389,95％ CI0.685 ～2.817,P=0.3621）与ABI异常之间无相关关系.结论 高危高血压患者动脉壁增厚和（或）血肌酐轻度升高与ABI异常的关系较为显著,而左心室肥厚和微量白蛋白尿与ABI异常的关系不明显.Objective To investigate the association of hypertensive target organ damage with abnormal ankle brachial index （ABI） in high-risk hypertensive patients.Methods During December 2008 to May 2009,a cross-sectional study was conducted to investigated the prevalence of abnormal ABI （ABI 〈 0.90） in 2674 community-dwelling,hypertensive patients,who aged 〉 40 years,without coronary heart disease,stroke/transient ischemic attack or known arteriosclerosis,from 18 centers in China. Data were acquired through history,physical examination,laboratory and other diagnostic tests.Results There were 2615 subjects eligible for the full analysis set. The high-risk hypertensive patients with arterial wall thickening,arterial wall thickening and slightly elevated serum creatinine had a higher prevalence of abnormal ABI than their counterparts respectively （ P 〈 0.05 ）. Compared with the normal group,the abnormal ABI group had a higher serum creatinine level on average （P 〈 0.01 ）.After adjustment for certain factors including investigation center,demographic factors,cardiovascular disease （CVD） risk and CVD risk factors using an unconditional logistic regression model,arterial wall thickening （ OR 2.416,95% CI 1.395-4.183,P =0.0016 ） and slightly elevated serum creatinine （ OR 3.377,95% CI 1.267-8.997,P =0.0149） were positively associated with abnormal ABI. However,arterial wall thickening （OR 0.988,95% CI 0.576-1.695,P=0.9664） and microalbuminuria （OR 1.389,95% CI0.685-2.817,P=0.3621）were irrelevant to abnormal ABI.Conclusions So far as a high-risk hypertensive patient is concerned,there are significant statistical correlations between arterial wall thickening and/or slightly elevated serum creatinine and an abnormal ABI,but no significant statistical correlations between arterial wall thickening or microalbuminuria and an abnormal ABI is observed.

关 键 词：高血压 靶器官损害 踝臂指数 

分 类 号：R544.1[医药卫生—心血管疾病]