围绝经期女性baPWV、ABI及血清Hcy、Lp(a)与心血管事件的相关性分析  

Correlation between baPWV,ABI,serum Hcy,Lp(a)and cardiovascular events in perimenopausal women

作　　者：席爱萍[1] 李欣[2] 刘可心 许岩丽[3] 桂艳红 王珅 XI Ai-ping;LI Xin;LIU Ke-xin(Affiliated Hospital of Hebei University of Engineering,Handan 056002,hina)

机构地区：[1]河北工程大学附属医院,河北邯郸056002 [2]河北省邯郸市第一医院 [3]河北工程大学医学院,河北邯郸056002

出　　处：《中国实验诊断学》2022年第6期799-803,共5页Chinese Journal of Laboratory Diagnosis

基　　金：河北省卫健委重点课题(N20210936)。

摘　　要：目的 分析围绝经期女性臂踝脉搏波传导速度(baPWV)、臂踝血压指数(ABI)及血清同型半胱氨酸(Hcy)、脂蛋白a[Lp(a)]与心血管事件的相关性。方法 选取2021年7月-2021年10月体检的1 000例围绝经期妇女,根据是否发生动脉粥样硬化性心血管疾病(ASCVD)分为ASCVD组和非ASCVD组,比较两组的临床资料和baPWV、ABI、Hcy、Lp(a)以及颈动脉内中膜厚度(cIMT)水平,采用Pearson法对ASCVD组baPWV、ABI、Hcy、Lp(a)水平和cIMT做相关性分析,采用Logistics回归分析围绝经期妇女发生ASCVD事件的独立危险因素,建立风险预测模型,采用Hosmer-Lemeshow拟合优度检验和受试者工作特征(ROC)曲线评估模型的拟合程度与预测效能。结果 ASCVD组的体质指数、baPWV、Hcy、Lp(a)、cIMT水平和合并糖尿病、高血压、高血脂、冠心病和烟酒史占比均高于非ASCVD组,ABI低于非ASCVD组(P<0.05),cIMT(OR=1.618)、Hcy(OR=1.454)、baPWV(OR=1.346)是影响围绝经期妇女发生ASCVD事件的独立危险因素(P<0.05),ASCVD组的baPWV、Hcy、Lp(a)水平与cIMT呈正相关,ABI水平与cIMT呈负相关(P<0.05),围绝经期妇女发生ASCVD事件风险预测模型为LogP=28.911+0.481×cIMT+0.374×Hcy+0.297×baPWV,经Hosmer-Lemeshow拟合优度检验P=0.511,预测模型的AUC为0.795(95%CI:0.696-0.874),灵敏度和特异度分别为64.10%和87.76%。结论 baPWV、ABI、Hcy、Lp(a)与cIMT具有较好的相关性,baPWV、Hcy和cIMT是围绝经期妇女发生ASCVD事件的独立危险因素,本研究建立的围绝经期妇女发生ASCVD的风险预测模型,具备一定的预测效能。Objective To analyze the correlation between brachial-ankle pulse wave velocity(baPWV),ankle-brachial index(ABI),serum homocysteine(Hcy),lipoprotein a[Lp(a)]and cardiovascular events in perimenopausal women.Methods A total of 1,000 perimenopausal women undergoing physical examination in the hospital were enrolled between July and October 2021.According to presence or absence of atherosclerotic cardiovascular disease(ASCVD),they were divided into ASCVD group and non-ASCVD group.The clinical data,baPWV,ABI,Hcy,Lp(a)and carotid intima-media thickness(cIMT)between the two groups were compared.The correlation between baPWV,ABI,Hcy,Lp(a)and cIMT was analyzed by Pearson method.The independent risk factors of ASCVD were analyzed by Logistic regression analysis.The risk prediction model was constructed.The fitting degree and predictive efficiency of the model were evaluated by Hosmer-Lemeshow test and receiver operating characteristic(ROC)curves.Results The body mass index,baPWV,Hcy,Lp(a),cIMT,proportions of cases with diabetes,hypertension,hyperlipidemia,coronary heart disease,smoking and drinking histories in ASCVD group were higher than those in non-ASCVD group,while ABI was lower than that in non-ASCVD group(P<0.05).cIMT(OR=1.618),Hcy(OR=1.454)and baPWV(OR=1.346)were independent risk factors of ASCVD in perimenopausal women(P<0.05).The levels of baPWV,Hcy and Lp(a)were positively correlated with cIMT,while ABI level was negatively correlated with it(P<0.05).The risk prediction model for ASCVD was as follow:LogP=28.911+0.481×cIMT+0.374×Hcy+0.297×baPWV.The results of Hosmer-Lemeshow goodness of fit test were as follows:P=0.511.AUC,sensitivity and specificity of the prediction model were 0.795(95%CI:0.696-0.874),64.10% and 87.76%,respectively.Conclusion There is good correlation between baPWV,ABI,Hcy,Lp(a)and cIMT.baPWV,Hcy and cIMT are independent risk factors of ASCVD in perimenopausal women.The risk prediction model is of good prediction efficiency.

关 键 词：围绝经期 臂踝脉搏波传导速度 臂踝血压指数 同型半胱氨酸 心血管事件 

分 类 号：R711[医药卫生—妇产科学]