肱-踝脉搏波传导速度与老年心血管病危险因素关系的研究  

Association of Braehial-ankle pulse wave velocity with cardiovascular disease in the elderly

作　　者：党连生[1] 刘美玲[1] 徐燕[1] 刘少旋[1] 宫武装[1] 朱王亮[1] 

机构地区：[1]包头医学院第一附属医院干部病房,014010

出　　处：《中国综合临床》2012年第5期476-480,共5页Clinical Medicine of China

基　　金：包头市科技局社会发展科技支撑项目（2010S2001.1）

摘　　要：目的探讨肱．踝脉搏波传导速度（baPWV）与心血管病危险因素的关系，为临床早期检测动脉硬化提供新途径。方法选择2010年11月至2011年10月于我院体检或住院的老年人共348例作为研究对象，其中男232例，女116例；平均年龄（74．5±9．0）岁。所有对象均接受问卷调查，记录病史，并测定baPWV，同时测量身高、体质量、腰围、甘油三酯（．TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）等指标。比较危险因素与baPWV的关系。结果（1）心血管危险因素数量越多，baPWV升高发生率越高。（2）多因素Logistic回归分析显示：年龄（OR=5．223，95％CI：3．606～7．564）、LDL—C升高（OR=4．554，95％CI：2．413～8．593）、吸烟（OR=6．007，95％CI：3．775～9．560）、肥胖（OR=3．019，95％CI：2．363～3．857）、高血压（OR=6．938，95％CI：3．591-13．404）、高盐饮食（OR=2．555，95％CI：2．108～3．096）是baPWV升高的独立危险因素（P均〈0．05）；运动（OR=0．941，95％C10．915～0．967）、睡眠（OR=0．947，95％C10．927～0．968）是baPWV升高的保护因素（P均〈0．05）。（3）按照运动时间将健康组分为运动组（运动时间≥1h／d）和少运动组（运动时间〈1h／d），按照是否失眠分失眠组和无失眠组，发现运动组的baPWV值明显低于少运动组[分别为：（1169．0±34．8）、（1370．0±51．7）cm／s，t=2．719，P=0．012]，无失眠组的baPWV值明显低于失眠组[分别为：（1205．0±29．4）、（1358．0±36．2）cm／s，t=2.561，P=0．017]，差异有统计学意义。（4）老年单纯高血压组baPWV为（1852．0±46．7）cm／s、糖尿病组baPWV为（1693．0±38．2）cm／s、冠心病组baPWV为（1729．04-40．4）crrds，较健康组[baPWV为（1356．0±31．3）cm／s]高，差异均有统计学意义（P均〈0．05）。但单纯高Objective To investigate the relationship between atherosclerosis and cardiovascular risk factors in the elderly, thus to provide new method for detection of atherosclerosis in the elderly. Methods From November 2010 to October 2011,348 elderly who addmitted to or had physical examination in our hospital were recruited in the study. All participants were interviewed through questionnaire, and medical history was recorded, Brachial-ankle pulse wave velocity （baPWV） was measured. Simultaneously, height, body weight, waist circumferrence, triglyceride （ TG ）, total cholesterol （ TC ）, high density lipoprotein-cholesterol （ HDL-C ）, low density lipoprotein-cholesterol （LDL-C）were measured. The association between baPWV and cardiovascular and atherosclerosis was investigated. Results The incidence of higher baPWV was increasing a＇s the number of risk factors of cardio vascular disease adding. Logistic regression analysis show that： Age （ OR = 5. 223,95% CI 3. 606 -7. 564） ,LDL-C（ OR = 4. 554,95% CI 2. 413 - 8. 593 ）, Smoking （ OR = 6. 007,95% CI 3. 775 - 9. 560）, Obesity （ OR = 3. 019,95% CI 2. 363 - 3. 857 ）, Hypertension （ OR = 6. 938,95% CI 3. 591 - 13.404 ）, High-salt diet（ OR = 2. 555,95% CI 2. 108 - 3. 096 ） were independent risk factors of baPWV incrdase （ P 〈 0. 05）; Exercise and good sleep were the protective factors for baPWV increasing. BaPWV levels were significantly lower in the exercise group（ exercise time 〉 1 h/d）than in the few exercise group（ exercise time 〈 1 h/d） （t = 2. 719, P = 0. 012）, and lower in good sleep group participants than in insomnia participants （t = 2. 561 ,P = 0. 017 ）（ P 〈 0. 05 ）. BaPWV, levels were significantly higher_in the group with essential hypertension （ 1852. 0 ± 46.7 cm/s）, with Type 2 Diabetes Mellitus （ 1693.0± 38.2 cm/s）, with coronary heart disease （ 1729. 0 ± 40.4 cm/s） than in the healthy group （ 1356.0 ±31.3 cm/s） （ P 〈0. 05 ）. There was no statistical differ

关 键 词：脉搏波传导速度 老年人 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]