开滦研究人群动脉硬化与隐匿性腔隙灶的关联性  

Association between arterial stiffness and silent lacunes:insights from the Kailuan Cohort

作　　者：张文飞 惠颖 李静 吴寿岭[3] 吴云涛[3] 杨羚 杨盈萍 李梦宁 柏蒙萌 陈晨 刘景旺 ZHANG Wenfei;HUI Ying;LI Jing;WU Shouling;WU Yuntao;YANG Ling;YANG Yingping;LI Mengning;BAI Mengmeng;CHEN Chen;LIU Jingwang(Kailuan General Hospital Affiliated to North China University of Science and Technology,Tangshan,Hebei 063000,China;Department of Radiological Diagnosis,Tsinghua Chang Gung Hospital,Beijing;Department of Cardiology,Kailuan General Hospital;School of Medicine,Tarim University;School of Public Health,Tongji Medical College,HuazhongUniversity of Science and Technology;Graduate School,Hebei North University)

机构地区：[1]华北理工大学附属开滦总医院核磁共振室,河北唐山063000 [2]北京清华长庚医院放射诊断科 [3]开滦总医院心内科 [4]塔里木大学医学院 [5]华中科技大学同济医学院公共卫生学院少儿卫生与妇幼保健学系 [6]河北北方学院研究生院

出　　处：《中华高血压杂志(中英文)》2025年第3期267-274,共8页Chinese Journal of Hypertension

基　　金：国家自然科学基金(82272072)。

摘　　要：目的探讨动脉硬化与隐匿性腔隙灶的关联。方法采用基于社区人群的观察性研究,选取2020—2023年参加第7次随诊且完成颅脑核磁检查的开滦集团在职和离退休职工为观察对象。根据臂-踝动脉脉搏波传导速度(baPWV)将研究人群分为非动脉硬化组(baPWV<14 m/s)、轻度动脉硬化组(baPWV 14~<18 m/s)、重度动脉硬化组(baPWV≥18 m/s)。以颅脑磁共振检查图像为确诊有无隐匿性腔隙灶的依据。采用多因素logistic回归模型和限制性立方样条图分析baPWV与隐匿性腔隙灶的关联。结果最终纳入分析的研究对象有1563例,平均年龄(54.5±11.6)岁,男性占51.8%。其中非动脉硬化组579例,轻度动脉硬化组686例,重度动脉硬化组298例。共有237例(15.2%)检出隐匿性腔隙灶。在校正潜在混杂因素后,logistic回归分析结果显示,隐匿性腔隙灶检出率随着baPWV增加而增加(baPWV每增加1个标准差,OR=1.26,95%CI 1.03~1.54,P=0.024);重度动脉硬化人群隐匿性腔隙灶的风险是非动脉硬化人群的2.62倍(95%CI1.40~4.93,P=0.003)。限制性立方样条显示当baPWV为15~<25 m/s时,baPWV与隐匿性腔隙灶风险呈正相关。结论baPWV与隐匿性腔隙灶呈正向关联及剂量-反应关系,重度动脉硬化患者的隐匿性腔隙灶风险明显高于非动脉硬化人群。Objective To investigate the association between arterial stiffness and silent lacunes.Methods An observational study based on the community population was conducted.The employees and retired employees of Kailuan group who participated in the 7th follow-up and completed brain magnetic resonance imaging(MRI)in 2020-2023 were selected as the subjects.According to the brachia-ankle pulse wave velocity(baPWV),the subjects were divided into non-arterial stiffness group(baPWV<14 m/s),mild arterial stiffness group(baPWV 14-<18 m/s)and severe arterial stiffness group(baPWV≥18 m/s).Brain MRI was used to detect the presence of silent lacunes.Multivariate logistic regression model and restrictive cubic spline were used to analyze the association between baPWV and the presence of silent lacunes.Results A total of 1563 subjects were included,aged(54.5±11.6)years,51.8%were male.There were 579 cases in non-arterial stiffness group,686 cases in mild arterial stiffness group and 298 cases in severe arterial stiffness group.Silent lacunes were detected among 237(15.2%)participants.After adjusting for potential confounding factors,logistic regression analysis showed that the odds ratio(OR)of silent lacunes increased with increasing baPWV(per stand deviation increase in baPWV,OR=1.26,95%CI 1.03-1.54,P=0.024);and participants with severe arterial stiffness had a higher risk of having silent lacunes compared to those without arterial stiffness(OR=2.62,95%CI 1.40-4.93,P=0.003).Restrictive cubic spline analysis showed that when baPWV was between 15 and<25 m/s,baPWV was positively correlated with the risk of silent lacunes.Conclusions There is a positive association and a dose-response relationship between baPWV and silent lacunes.The risk of silent lacunes is significantly higher in individuals with severe arterial stiffness compared to the population without arterial stiffness.

关 键 词：动脉硬化 脑小血管病 臂踝动脉脉搏波传导速度 隐匿性腔隙灶 

分 类 号：R743[医药卫生—神经病学与精神病学]