新指标评估结缔组织病患者动脉僵硬度及其对左心室舒张功能的影响  

Arterial Stiffness Assessed by New Indices in Patients with Connective Tissue Disease and Their Association with Left Ventricular Diastolic Function

作　　者：杨子玄 刘圣 亢玉[1] 张庆[1] YANG Zixuan;LIU Sheng;KANG Yu;ZHANG Qing(Department of Cardiology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China;Department of Cardiology,Dianjiang People’s Hospital of Chongqing,Chongqing 408399,China)

机构地区：[1]四川大学华西医院心内科,四川成都610041 [2]重庆市垫江县人民医院心内科,重庆408399

出　　处：《心血管病学进展》2022年第5期475-480,共6页Advances in Cardiovascular Diseases

基　　金：四川省科技厅重点研发项目(2017SZ0059)。

摘　　要：目的利用新型动脉僵硬度指标动脉波速指数(AVI)和动脉压力容积指数(API),对结缔组织病(CTD)患者的中心动脉与外周动脉僵硬度进行评估,并探索其与左心室舒张功能障碍(LVDD)的关系。方法于2019年4—7月连续纳入住院CTD患者作为病例组(n=150),按照3:1同期纳入性别和年龄匹配的非CTD患者为对照组(n=50),采用t检验比较两组患者的临床特征、AVI和API的差异。在CTD病例组内,采用多元线性回归分析AVI和API的影响因素,采用二元逻辑回归探究AVI和API与LVDD的关联。结果病例组收缩压[(120±18)mm Hg vs(113±16)mm Hg,P=0.009],AVI(17±6 vs 15±4,P=0.005),API(25±6 vs 23±4,P=0.007),以及LVDD(+)占比(24.7%vs 8.0%,P=0.014)均显著高于对照组。在病例组内,AVI和API均与年龄和收缩压呈独立正相关(P<0.05),此外,AVI还与C反应蛋白独立相关(标准化β=0.131,P=0.042)。经矫正年龄、身体质量指数、血压和CTD病程,AVI与LVDD(+)独立相关(OR=1.129,P=0.015),而API与之无相关性。结论CTD患者的新型动脉僵硬度指标AVI和API高于非CTD患者,且C反应蛋白增高、AVI升高以及合并LVDD之间具有相关性。CTD如何导致AVI和API升高以及其在心血管危险分层中的意义仍需进一步研究。Objective To assess the stiffness of central and peripheral arteries in patients with connective tissue disease(CTD)by using the new indices,arterial velocity pulse index(AVI)and arterial pressure volume index(API),and to explore the association between arterial stiffness and left ventricular diastolic dysfunction(LVDD).Methods From April to July 2019,hospitalized CTD patients were continuously included as the case group(n=150),and non-CTD patients matched by gender and age were included as the control group(n=50)at the same time according to 3:1.The differences of clinical characteristics,AVI and API between the two groups were compared by t-test.In the case group,multiple linear regression was used to explore the factors associated with AVI and API,and binary logistic regression was used to investigate the association between AVI,API and LVDD.Results The CTD group had higher systolic blood pressure[(120±18)mm Hg vs(113±16)mm Hg,P=0.009],AVI(17±6 vs 15±4,P=0.005),API(25±6 vs 23±4,P=0.007),and proportion of LVDD(+)(24.7%vs 8.0%,P=0.014)than the control group.Among CTD patients,both AVI and API were positively related to age and systolic blood pressure(P<0.05),but AVI was also independently correlated with C-reactive protein(standardizedβ=0.131,P=0.042).After adjusting for age,body mass index,blood pressure and CTD course,AVI was independently correlated with LVDD(+)(OR=1.129,P=0.015),but API was not correlated with it.Conclusion The new arterial stiffness indexes(AVI and API)in CTD patients were higher than those in non-CTD patients,and there was a correlation between the increase of CRP,AVI and LVDD.How CTD leads to the increase of AVI and API and its significance in cardiovascular risk stratification still need to be further studied.

关 键 词：结缔组织病 动脉僵硬度 动脉波速指数 动脉压力容积指数 左心室舒张功能障碍 

分 类 号：TP3[自动化与计算机技术—计算机科学与技术]