动脉硬化早期检测临床研究  

The clinic study for early measurement of arteriosclerosis cases

作　　者：章志玲[1] 刘秋玲[2] 王云霞[2] 吴志婷[2] 葛郁芝[2] 

机构地区：[1] 江西省人民医院干心血管一科, 南昌市,330006 [2] 江西省心血管病研究所

出　　处：《中国心血管病研究》2014年第2期125-129,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 研究评价动脉硬化的指标臂踝脉搏波传导速度（baPWV）和踝臂血压指数（ABI）与心血管疾病发生及其危险因素间的关系,探讨其作为冠心病,颈动脉粥样硬化斑块等心血管疾病预测指标的临床价值以及硝酸甘油对ABI和baPWV的影响.方法 以本院门诊和住院患者1000例为研究对象,男性713例,女性287例,年龄（69.51±15.18）岁,采用VP-1000全自动动脉硬化测定仪检测患者双侧baPWV和ABI.其中150例疑为冠心病者行冠状动脉造影检查,154例行颈动脉超声多普勒检测颈动脉粥样硬化斑块情况.结果 ①baPWV与高血压直接相关（OR =6.528,95％CI=3.137 ～12.763,P＜0.05）,与吸烟（OR=6.446,95％CI=2.411～17.235）、高脂血症（OR =4.694,95％CI=2.200～10.014）、性别（男性）（OR =3.100,95％CI=1.106～8.687）和冠心病（OR=1.795,95％0=1.020～3.894）密切相关（P＜0.05）.随着心血管疾病危险因素聚集,动脉硬化的发生率明显增加.②baPWV在评估冠心病中的价值：冠状动脉造影阳性组与冠脉造影阴性组比较,baPWV＞ 1700 cm/s,敏感性83.33％、准确性84.00％,Kappa值0.61.③颈动脉粥样硬化斑块与baPWV的关系：颈动脉粥样硬化斑块与年龄、baPWV、吸烟史、脉压相关（P＜0.05）;随着baPWV的升高,颈动脉粥样硬化斑块的OR值增加.④含服硝酸甘油对baPWV与ABI的影响：服药后所有受试对象的baPWV值均减小（P＜0.01）,baPWV变化与用药前的收缩压和年龄呈正相关.服药后所有受试对象的ABI值均减小（P＜0.01）,ABI的变化与用药前心率呈负相关,与用药后的心率呈正相关.结论 ①baPWV值可能是冠心病、颈动脉粥样硬化斑块发生的独立预测因子.②硝酸甘油可改善ABI和baPWV测量值,其临床意义有待进一步探讨.Objective To study the correlation of ABI, baPWV and coronary heart disease （CHD）, carotid atherosclerosis （CAS）. To study the effects of nitroglycerin on value of ABI and baPWV. Methods 1000 individuals were measured by the VP-1000 automatic arteriosclerosis measurement system. Coronary anglograph was performed in 150 patents. Doppler echocardiographic examination for carotid artery was performed in 154 patients. Results （1）Tbe relationship between ba-PWV and occurrence or risk factors of arteriosclerosis evaluated by baP- WV. It was found that hypertension （0R=6.528,95%CI=3.137-12.763）, smoking （0R=6.446,95%C[=2.411- 17.235 ）, hyperlipidemia （OR =4.694,95% CI=2.200-10.014）, gender （male） （ OR =3.100,95% CI= 1.106- 8.687 ） and CHD （0R=1.795,95%CI=1.020-3.894） were related to arteriosclerosis （P〈0.01）. The incidence of arte- riosclerosis was increasing as the number of risk factors of cardiovascular disease adding. （2）It was found that baP- WV〉1700 cm/s as indictor of CHD, the sensitivity 83.33%, veracity 84.00% and value of Kappa is 0.61. （3）CAS rehtted with age, baPWV, smoking and pulse press （P〈0.05）. As baPWV increasing, the OR of carotid atheroselerosis was raising. With age and baPWV adding, the morbidity of CAS was increasing. （4）The effects of nitroglycerin on the baPWV and ABI. After taking medicine of nitroglycerin, the value of baPWV was diminished （P〈 0.01）. Coneltmion （1）baPWV could be indictor of CHD, carotid atherosclerosis. （2）Nitroglycerin can improve the value of baPWV and ABI, the clinic value should be further to research.

关 键 词：动脉硬化 踝臂血压指数 臂踝脉搏波传导速度 冠状动脉粥样硬化性疾病 硝酸甘油 

分 类 号：R541.4[医药卫生—心血管疾病]