安徽地区18~59岁体检人群颈股脉搏波速度的分布及影响因素  

Distribution and related factors of carotid-femoral pulse wave velocity in health check-up population aged 18-59 in Anhui region

作　　者：周镇森 侯小文 程思为 张晓雨[3] 谢晖 杨先军 马祖长 ZHOU Zhen-sen;HOU Xiao-wen;CHENG Si-wei;ZHANG Xiao-yu;XIE Hui;YANG Xian-jun;MA Zu-chang(Department of Nursing,Bengbu Medical University,Bengbu 233030,China;Hefei Institutes of Physical Science,Chinese Academy of Sciences,Hefei 230031,China;Health Management Center,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]蚌埠医科大学护理学院,安徽省蚌埠市233030 [2]中科院合肥物质科学研究院运动健康中心 [3]安徽医科大学第一附属医院健康管理中心

出　　处：《中国心血管病研究》2024年第8期700-706,共7页Chinese Journal of Cardiovascular Research

基　　金：国家重点研发计划(2022YFC2010200);国家自然科学基金面上项目(62133004)。

摘　　要：目的探索安徽地区体检人群颈股脉搏波传导速度(cfPWV)的分布及相关影响因素,为早期预防心血管疾病提供依据。方法对安徽医科大学第一附属医院和中科院合肥肿瘤医院健康管理中心的734名18~59岁体检者进行一般资料调查、血液学检测和cfPWV测量。采用控制年龄的偏相关分析cfPWV的相关因素。采用多元逐步回归分析cfPWV的独立影响因素。以是否发生主动脉硬化为结局变量(cfPWV≤10 m/s表示未发生=0,cfPWV>10 m/s表示发生=1),采用多因素logistic回归分析主动脉硬化的独立影响因素。结果18~59岁人群中,年龄增长对女性cfPWV的影响更显著。调整年龄后,男性cfPWV平均值显著高于女性(9.2 m/s比8.7 m/s,P<0.05)。控制年龄的偏相关分析结果显示,cfPWV与收缩压(SBP)、舒张压(DBP)、血红蛋白(Hb)和空腹血糖(FBG)呈显著正相关。男性cfPWV与心率、尿酸(UA)、甘油三酯(TG)呈显著正相关,与尿素水平呈显著负相关(P<0.05)。多元线性回归分析结果显示,平均动脉压(MAP)、年龄、性别、FBG和尿素水平是cfPWV的独立影响因素。多因素logistic分析结果显示,年龄、MAP、FBG和Hb是主动脉硬化的独立危险因素。基于以上四个指标预测主动脉硬化的AUC为0.928(95%CI 0.903~0.953),敏感度为0.913,特异度为0.815,准确率为87.60%。结论在18~59岁体检人群中,女性cfPWV更易受年龄的影响。cfPWV与MAP、年龄、性别、FBG呈显著正相关,与尿素水平呈显著负相关。此外,年龄、MAP、FBG和Hb是主动脉硬化发生的独立危险因素,基于以上四个指标能够准确预测主动脉硬化的发生风险。Objective To investigate the distribution of carotid-femoral pulse wave velocity(cfPWV)and its associated influencing factors in the health examination population in the Anhui region to provide a basis for early prevention of cardiovascular disease.Methods A survey of general information,hematological tests,and cfPWV measurements on 734 individuals aged 18 to 59 who underwent health examinations at the Health Management Centers of the First Affiliated Hospital of Anhui Medical University and the Hefei Cancer Hospital of the Chinese Academy of Sciences was conducted.The correlation factors of cfPWV were analyzed using age-adjusted partial correlation.Multiple stepwise regression was used to analyze the independent factors influencing cfPWV,and the regression equation was established.Using the occurrence of aortic sclerosis as the outcome variable(cfPWV≤10 m/s indicating no occurrence=0,cfPWV>10 m/s indicating occurrence=1),multivariate logistic regression analysis was used to identify the independent risk factors for aortic atherosclerosis.Results The effect of increasing age on cfPWV was more significant in women aged 18-59.After adjustment for age,the mean cfPWV in men was significantly higher than that in women(9.2 m/s vs.8.7 m/s,P<0.05).The results of age-adjusted partial correlation analysis showed that cfPWV was significantly positively correlated with systolic blood pressure(SBP),diastolic blood pressure(DBP),hemoglobin(Hb)and fasting blood glucose(FBG).Male cfPWV had a significant positive correlation with heart rate,uric acid(UA)and triglyceride(TG),but a significant negative correlation with urea(P<0.05).Multiple linear regression results showed that mean arterial pressure(MAP),age,sex,FBG and urea levels were the independent factors influencing cfPWV.The results of the multivariate logistic analysis showed that age,MAP,FBG and Hb were the independent risk factors for aortic sclerosis.Based on these four indicators,the predictive performance for aortic atherosclerosis yielded an AUC of 0.928(95%CI 0.90

关 键 词：颈股脉搏波传导速度 主动脉硬化 血管功能 早期筛查 影响因素 

分 类 号：R541.4[医药卫生—心血管疾病]