血管危险因素、踝肱指数与下肢动脉硬化闭塞症患者合并慢性静脉功能不全的相关性分析  

Association Analysis of Vascular Risk Factors,Ankle Brachial Index with Lower Extremity Atherosclerosis Occlusive Disease Complicated by Chronic Venous Insufficiency

作　　者：刘月 刘金波[1] 刘欢[1] 张琼阁 赵娜 赵红薇[1] 王宏宇[1,2,3,4,5] LIU Yue;LIU Jinbo;LIU Huan;ZHANG Qiongge;ZHAO Na;ZHAO Hongwei;WANG Hongyu(Vascular Medicine Center,Peking University Shougang Hospital,Beijing 100144,China;Beijing Shijingshan District Key Clinical Specialty of Vascular Medicine,Beijing 100144,China;Vascular Health Research Center of Peking University Health Science Center(VHRC-PKUHSC),Beijing 100144,China;Key Laboratory of Molecular Cardiovascular Sciences,Ministry of Education,Peking University,Beijing 100144,China;Heart and Vascular Health Research Center of Peking University Clinical Research Institute(HVHRC-PUCRI),Beijing 100144,China)

机构地区：[1]北京大学首钢医院血管医学中心,北京100144 [2]北京市石景山区血管医学重点专科,北京100144 [3]北京大学医学部血管健康研究中心,北京100144 [4]北京大学分子心血管学教育部重点实验室,北京100144 [5]北京大学临床研究所心脏和血管健康研究中心,北京100144

出　　处：《心血管病学进展》2022年第6期554-558,共5页Advances in Cardiovascular Diseases

摘　　要：目的分析血管危险因素与下肢动脉硬化闭塞症合并慢性静脉功能不全(LEAOD-CVI)患者的关系以及其踝肱指数(ABI)的特征。方法选择2016—2019年于北京大学首钢医院血管医学科就诊的LEAOD患者562例。CVI患者纳入合并组共94例,无CVI纳入单病组共468例。采用Pearson相关性分析、logistic回归分析分析血管危险因素和ABI与LEAOD-CVI的关系。结果合并组具有更低的糖尿病和高脂血症的患病率、空腹血糖和糖化血红蛋白水平(Z=4.93,P=0.02;Z=4.46,P=0.04;Z=-1.97,P=0.04;Z=-2.42,P=0.02),更高的高同型半胱氨酸血症患病率和ABI(Z=5.75,P=0.02;Z=-3.79,P<0.01)。糖尿病、糖化血红蛋白和高脂血症与LEAOD-CVI具有负相关关系(r=-0.10,P=0.03;r=-0.11,P=0.01;r=-0.09,P=0.04)。高同型半胱氨酸血症与LEAOD-CVI具有正相关关系(r=0.10,P=0.02)。糖尿病、空腹血糖、糖化血红蛋白、高脂血症和高同型半胱氨酸血症是LEAOD-CVI的影响因素(β=-0.51,P=0.03;β=-0.12,P=0.04;β=-0.28,P=0.01;β=-0.54,P=0.04;β=0.58,P=0.02)。调整多影响因素的作用后,仅高同型半胱氨酸血症是LEAOD-CVI的独立影响因素(调整后β=0.52,P=0.02)。结论与未合并CVI的LEAOD患者相比,LEAOD-CVI具有更高的ABI水平和高同型半胱氨酸血症患病率。高同型半胱氨酸血症是LEAOD-CVI的独立影响因素。当LEAOD-CVI时,需慎重考量把ABI作为LEAOD严重程度分级的标准。Objective To investigate the association of vascular risk factors with lower extremity atherosclerosis occlusive disease complicated by chronic venous insufficiency(LEAOD-CVI)and the characteristic of ankle brachial index(ABI).Methods A total of 562 LEAOD patients admitted in the Department of Vascular Medicine,Peking University Shougang Hospital from 2016 to 2019 were enrolled and assigned in comorbidity group with CVI(n=94)and single disease group without CVI(n=468).The relationship of vascular risk factors and ABI with LEAOD-CVI was calculated by Pearson correlation and logistic regression analysis.Results The comorbidity group showed a lower prevalence of diabetes mellitus(DM)and hyperlipidemia,fasting blood glucose(FBG)and HbA1c(Z=4.93,P=0.02;Z=4.46,P=0.04;Z=-1.97,P=0.04;Z=-2.42,P=0.02),a higher prevalence of hyperhomocysteine and ABI(Z=5.75,P=0.02;Z=-3.79,P<0.01).LEAOD-CVI was negatively correlated with DM,HbA1c,hyperlipidemia(r=-0.10,P=0.03;r=-0.11,P=0.01;r=-0.09,P=0.04)but positively correlated with hyperhomocysteine(r=0.10,P=0.02).DM,FBG,HbAlc,hyperlipidemia and hyperhomocysteine were the influence factors for LEAOD-CVI(β=-0.51,P=0.03;β=-0.12,P=0.04;β=-0.28,P=0.01;β=-0.54,P=0.04;β=0.58,P=0.02).After adjusted for confounding factors,only hyperhomocysteine was an independent risk factor for LEAOD-CVI(adjustedβ=0.52,P=0.02).Conclusion Compared to LEAOD without CVI,LEAOD-CVI showed a higher ABI level and a higher prevalence of hyperhomocysteine,which was an independent influence factor for LEAOD-CVI.Meanwhile,ABI should be carefully considered as the standard to classify LEAOD severity for LEAOD-CVI patients.

关 键 词：下肢动脉硬化闭塞症 慢性静脉功能不全 血管危险因素 踝肱指数 

分 类 号：R58[医药卫生—内分泌]