动态动脉硬化指数与老年冠心病的相关性研究  

Association between ambulatory arterial stiffness index and coronary heart disease in the elderly

作　　者：郑琴[1] 黄波[1] 孙燕淑[1] 刘梅林[1] 

机构地区：[1]北京大学第一医院老年内科,100034

出　　处：《中华老年心脑血管病杂志》2016年第5期470-473,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家科技支撑计划(2012BAI37B00)

摘　　要：目的探讨动态动脉硬化指数（AASI）与老年冠心病的发生及冠状动脉病变严重程度的关系。方法 267例拟诊冠心病的老年患者均行冠状动脉造影检查,得到患者冠状动脉病变的支数,并计算Gensini评分。根据冠状动脉造影结果分为冠心病组219例,非冠心病组48例;将冠心病组又分为单支病变组62例,双支病变组71例和3支病变组86例;对所有病例按Gensini评分的三分位数分为Gensini评分低分组86例（≤15分）、中分组92例（16-42分）及高分组89例（≥43分）。测量患者24h动态血压并计算AASI。结果冠心病组AASI显著高于非冠心病组（0.51±0.13 vs 0.46±0.15,P〈0.05）。与非冠心病组比较,双支病变组和3支病变组AASI水平显著升高（0.53±0.14、0.51±0.12 vs 0.46±0.15,P〈0.05）,单支病变组与非冠心病组比较差异无统计学意义（P〉0.05）。Gensini评分中分组和高分组AASI显著高于低分组（0.51±0.14、0.52±0.13 vs 0.45±0.14,P〈0.01）。多元线性回归分析示,性别、AASI、踝肱指数与Gensini评分独立相关（β=0.224,P=0.001;β=0.145,P=0.025;β=-0.261,P=0.000）。结论 AASI对老年冠心病的发生及冠状动脉病变的严重程度有一定的预测价值。Objective To study the association between ambulatory arterial stiffness index（AASI）and coronary heart disease（CHD）in the elderly.Methods The number of diseased branches and the Gensini score were calculated by coronary angiography in 267 elderly patients.The patients were divided into CHD group（n=219）and CHD-free group（n=48）.The patients in CHD group were further divided into single branch lesion group（n=62）,double branch lesion group（n=71）and triple branch lesion group（n=86）according to their coronary angiography.The 267 elderly patients were divided into≤15Gensini score group（n=86）,16-42 Gensini score group（n=92）and≥43Gensini score group（n=89）.Their 24 hambulatory blood pressure was measured and their AASI was calculated.Results The AASI was significantly higher in CHD group,double branch lesion group and triple branch lesion group than in CHD-free group（0.51±0.13 vs0.46±0.15,0.53±0.14 vs 0.46±0.15,0.51±0.12 vs 0.46±0.15,P〈0.05）.No significant difference was found in AASI between single branch leasion group and CHD-free group（P〉0.05）.The AASI was significantly higher in 16-42 Gensini score group and ≥43Gensini score group than in ≤15Gensini score group（0.51±0.14 vs 0.45±0.14,0.52±0.13 vs 0.45±0.14,P〈0.01）.Multivariate linear regression analysis showed that gender,AASI and ABI were independently associated with the Gensini score（β=0.224,P=0.001;β=0.145,P=0.025;β=-0.261,P=0.000）.Conclusion AASI plays a certain role in predicting the occurrence and severity of CHD in the elderly.

关 键 词：动脉硬化 冠状血管造影术 血压监测 便携式 

分 类 号：R541.4[医药卫生—心血管疾病]