大动脉炎患者四肢血压与颈动脉狭窄的关联  

Correlation between Four- limb Blood Pressure and Carotid Artery Stenosis in Patients with Takayasu Arteritis

作　　者：王倩[1] 蒋雄京[1] 董徽[1] 李弘武[1] 郑智豪 陈阳[1] 宋雷[1] 张慧敏[1] 邹玉宝[1] WANG Qian;JIANG Xiongjing;DONG Hui;LI Hongwu;ZHENG Zhihao;CHEN Yang;SONG Lei;ZHANG Huimin;ZOU Yubao(Department of Cardiology,State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院北京协和医学院,国家心血管病中心,阜外医院心血管疾病国家重点实验室心血管内科,北京100037

出　　处：《中国分子心脏病学杂志》2024年第4期6208-6213,共6页Molecular Cardiology of China

基　　金：国家自然科学基金面上项目(82170449)。

摘　　要：目的 研究大动脉炎患者臂间收缩压差值(sIAD)及踝臂指数(ABI)与颈动脉狭窄的关联。方法 连续收集2018年12月至2022年12月中国医学科学院阜外医院收治的165例大动脉炎患者的临床资料进行回顾性分析。按头臂动脉、颈总动脉、颈内动脉一处或多处直径狭窄≥50%将其分为颈动脉狭窄组及非颈动脉狭窄组。采集患者基本信息,测量四肢血压,并结合相关检查结果,应用logistic回归分析法分析大动脉炎患者颈动脉狭窄的影响因素。结果 本组165例大动脉炎患者中,sIAD≥10 mmHg(1 mmHg=0.133 kPa)的患者80例,检出率为48.5%(80/165);sIAD为8.0(3.0,22.5)mmHg。颈动脉狭窄组82例,非颈动脉狭窄组83例。颈动脉狭窄组女性患者占比、发病年龄、正规治疗年龄、高血压占比、sIAD、ABI、C反应蛋白水平及ba-PWV均高于非颈动脉狭窄组,颈动脉狭窄组患者血红蛋白低于非颈动脉狭窄组,且差异均有统计学意义(P均<0.05)。Logistic回归分析结果显示,sIAD≥10 mmHg[比值比(OR)=3.440,95%置信区间(95%CI):1.623~7.295,P=0.001]、ABI≥1.4(OR=7.069,95%CI:2.391~20.901,P<0.001)是大动脉炎患者颈动脉狭窄的独立危险因素。结论 大动脉炎患者sIAD升高,sIAD≥10 mmHg的检出率增高。sIAD≥10 mmHg及ABI≥1.4是大动脉炎患者颈动脉狭窄的独立危险因素。Objective To investigate the relationship of the inter-arm systolic blood pressure difference(sIAD) and ankle-brachial index(ABI) with carotid artery stenosis in patients diagnosed with Takayasu arteritis.Methods Patients hospitalized and diagnosed with Takayasu arteritis at Fuwai Hospital from December 2018 to December 2022 were consecutively enrolled.Patients were categorized into two groups based on the presence or absence of carotid artery stenosis,defined as≥ 50% diameter stenosis in cephalic brachial arteries,common carotid arteries,or internal carotid arteries at one or more sites.Basic information,four-limb blood pressure,and relevant examination results were collected and retrospectively analyzed.Results The study recruited a total of 165 Takayasu arteritis patients with an average age of(33.6±12.4) years,including 140 females(84.9%).Of these,80 patients exhibited an sIAD ≥ 10 mmHg(1 mmHg=0.133 kPa),with a detection rate of 48.5%,and sIAD was 8.0(3.0,22.5) mmHg.A total of 82 patients(49.7%) comprised the carotid artery stenosis group,while the non-stenosis group included 83 patients(50.3%).Variables that showed significance in the initial comparative analysis included gender,age of onset,age at formal treatment,sIAD,ABI,brachial-ankle pulse wave velocity,hemoglobin concentration,C-reactive protein,and comorbid hypertension.These variables were subsequently included in the binary logistic regression analysis.The results indicated that sIAD≥10 mmHg(adds ratio [OR]=3.440,95% confidence interval[95%CI]:1.623-7.295,P=0.001) and ABI≥1.4(OR=7.069,95%CI:2.391-20.901,P<0.001) were positively associated with the presence of carotid artery stenosis,affirming them as independent risk factors for carotid artery stenosis in patients with Takayasu arteritis.Conclusion Elevated sIAD values and increased detection rates of carotid artery stenosis in Takayasu arteritis patients were observed in this study.The findings suggest that sIAD≥10 mmHg and ABI≥1.4 are significant independent risk factors for carotid a

关 键 词：大动脉炎 臂间收缩压差 踝臂指数 脉搏波传导速度 颈动脉狭窄 

分 类 号：R543.5[医药卫生—心血管疾病]