不同收缩压水平对臂踝脉搏波传导速度影响的研究  

Effect of different levels of systolic blood pressure on brachial-ankle pulse wave velocity

作　　者：王义[1] 陶杰[3] 董岩[5] 陈朔华[4] 高新颖[3] 季春鹏[3] 杨光[3] 郑瑶[3] 吴寿岭[2] 

机构地区：[1]河北联合大学附属开滦总医院,唐山063000 [2]河北联合大学附属开滦总医院心内科,唐山063000 [3]河北联合大学附属开滦总医院研究生院,唐山063000 [4]河北联合大学附属开滦总医院开滦员工健康保障中心,唐山063000 [5]河北联合大学附属开滦总医院林西医院,唐山063000

出　　处：《中华流行病学杂志》2014年第6期655-659,共5页Chinese Journal of Epidemiology

摘　　要：目的：探讨不同收缩压（SBP）水平对臂踝脉搏波传导速度（baPWV）的影响。方法在101510名参加2006-2007年开滦集团职工健康体检者中随机分层抽取5852人作为研究对象进行横断面研究，采用统一问卷调查、血液生化及baPWV检查，其中符合入选标准（年龄≥40岁、既往无缺血性脑卒中、短暂性脑缺血发作、心肌梗死者）5440人，将资料完整的5222人纳入统计分析。依据2010-2011年度体检时SBP值将研究对象分为理想SBP组（SBP＜120 mmHg）、正常高值Ⅰ期组（120 mmHg≤SBP＜130 mmHg）、正常高值Ⅱ期组（130 mmHg≤SBP＜140 mmHg）、高血压组（SBP≥140 mmHg或＜140 mmHg但正在服用降压药物者）。利用多因素logistic回归分析不同SBP水平对baPWV的影响。结果（1）5222（男性3132，女性2090）名研究对象平均年龄55.1岁，平均baPWV（1587.57±400.71）cm/s，baPWV≥1400 cm/s的检出率为62%；（2）4组人群平均baPWV分别为1322.19、1456.27、1544.78、1827.77 cm/s，baPWV≥1400 cm/s的检出率分别为26.4%、49.3%、64.2%、88.3%；（3）多因素线性回归分析显示SBP的标准化β值为0.40，仅次于年龄的0.48；（4）影响baPWV的多因素logistic回归分析显示，校正年龄、性别等因素后，与理想SBP组比较，正常高值Ⅰ期、正常高值Ⅱ期和高血压组均为baPWV≥1400 cm/s的危险因素，OR值分别为2.70（95%CI：2.20～3.32）、4.56（95%CI：3.67～5.67）和13.51（95%CI：10.87～16.78）。结论SBP升高是baPWV增加的独立危险因素。Objective To investigate the impact of different levels of systolic blood pressure on brachial-ankle pulse wave velocity（baPWV）. Methods A total of 5 852 participants was selected with stratified random sampling from the 101 510 workers of Tangshan Kaiuan Company who had undergone a physical check-up program. 5 222 of them with integral data were recruited into this survey. According to SBP collected during the 2010-2011 health examination program,the population under observation was divided into four groups：optimal SBP（SBP〈120 mmHg）,high-normal blood pressure Ⅰ period（120 mmHg≤SBP〈130 mmHg）,high-normal blood pressure Ⅱ period （130 mmHg≤SBP〈140 mmHg）and hypertension（SBP≥140 mmHg or SBP〈140 mmHg but antihypertensive drug user）. Multivariate logistic regression analysis was used to analyze the influence of different levels of systolic blood pressure on baPWV. Results 1）There were 3 132 males and 2 090 females in all the 5 222 participants with an average age of 55.1 years old. Their mean of baPWV was（1 587.57±400.71）cm/s,with the detection rates as 62%（baPWV≥1 400 cm/s）. 2）The means of baPWV for the above groups of SBP were 1 322.19,1 456.27,1 544.78 and 1 827.77 cm/s, respectively,with detection rates of baPWV≥1 400 cm/s as 26.4%,49.3%,64.2% and 88.3%, respectively. 3）Results from the Multiple linear regression analysis revealed that β of SBP was 0.40,only ranking second,on age（0.48）. 4）Data from the Multiple logistic regression analysis showed that after adjusting for age,gender and other risk factors,when compared to optimal SBP,factors as high-normal blood pressure Ⅰ period、high-normal blood pressure Ⅱ period and hypertension were risk factors for increasing baPWV,with OR values as 2.70（95%CI：2.20-3.32）,4.56（95%CI：3.67-5.67）and 13.51（95%CI：10.87-16.78）,respectively. Conclusion Higher SBP seemed an independent risk factor for the increase of baPWV.

关 键 词：收缩压 臂踝脉搏波传导速度 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]