超声检查评估不同海拔地区代谢综合征患者血管内皮功能及相关危险因素的分析  

Abnormal vascular endothelial function and risk factors in patients with metabolic syndrome in different altitude areas

作　　者：温智峰[1] 刘晓宇[1] 张文[1] WEN Zhifeng;LIU Xiaoyu;ZHANG Wen(Department of Ultrasonography,Qinghai Provincial TCM Hospital,Xining 810000,China)

机构地区：[1]青海省中医院超声科,西宁810000

出　　处：《浙江医学》2021年第22期2441-2444,共4页Zhejiang Medical Journal

基　　金：青海省卫生健康系统重点课题项目(2019-wjzd-12)。

摘　　要：目的应用超声检查探讨不同海拔地区代谢综合征(MS)患者血流介导的血管内皮舒张功能(FMD)及相关危险因素的分析。方法选择2018年6月至2020年3月青海省中医院符合纳入标准并同意参加本研究的MS患者100例(高、低海拔各50例,MS组)和正常人100例(高、低海拔各50例,正常组)。应用超声检查测定两组对象肱动脉FMD;分析两组FMD异常者性别、年龄、血压、BMI及各项生化指标的差异,采用logistic回归分析MS患者FMD异常的危险因素。结果MS组FMD异常率为66.0%(66/100),正常组为15.0%(15/100),差异有统计学意义(χ2=53.968,P<0.05)。高、低海拔MS患者及正常者FMD异常率的差异均无统计学意义(均P>0.05)。单因素分析结果显示,FMD异常与正常者的糖化血红蛋白(HbA1C)、FPG、2 h餐后血糖(PBG)、BMI、血尿酸(UA)、Hb、二氧化碳分压(PO2)、收缩压(SBP)、舒张压(DBP)、TG、HDL-C及年龄比较差异均有统计学意义(均P<0.05)。logistic回归分析显示,TG、BMI和年龄是FMD异常的危险因素。结论高海拔地区MS患者存在较广泛的血管内皮功能障碍,其中TG、BMI和年龄起着关键作用。Objective To investigate the abnormal vascular endothelial function and risk factors in patients with metabolic syndrome(MS)in different altitude areas.Methods From June 2018 to March 2020,50 MS patients and 50 normal subject living at high altitude areas(3000 m above sea level),50 MS patients and 50 normal subjects living at low altitude areas(1780-2999 m above sea level)were recruited in the study.The flow mediated dilatation(FMD)of brachial arteries was measured by high-resolution color Doppler ultrasound as the indicator of endothelium-dependent diastolic function in the two groups.The correlation of FMD with the gender,age,blood sugar,glycosylated hemoglobin,triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),C-reactive protein(CRP),body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP)and hemoglobin was analyzed.The risk factors of abnormality of FMD was determined with logistic regression.Results There were 66 cases with abnormal FMD in MS patients with an abnormal rate of 66.0%,and 15 cases with abnormal FMD in normal subjects with an abnormal rate of 15.0%(P<0.05).There were 37 cases of abnormal FMD in high altitude MS patients and 29 cases of abnormal FMD in low altitude MS patients(P>0.05).There were 9 cases of abnormal FMD in the normal subjects at high altitude and 6 cases in the normal population at low altitude(P>0.05).The univariate analysis showed that abnormal FMD was associated with HbA1C,FPG,PBG,BMI,UA,Hb,PO2,SBP,DBP,TG,HDL-C,gender and age(P<0.05).Multivariate logistic regression analysis showed that TG,BMI and age were independent risk factors for abnormality of endothelial function.Conclusion MS patients have extensive endothelial dysfunction,and TG,BMI and age are risk factors.

关 键 词：超声检查 海拔 代谢综合征 血管内皮功能 

分 类 号：R589[医药卫生—内分泌]