背景:近年来研究认为内皮功能是动脉粥样硬化性疾病的新的独立危险因子,但藏汉两族人群内皮功能的差异尚未得到充分研究.目的:比较藏汉两族人群内皮功能的差异,同时比较血脂及肥胖相关指标.设计:对比分析.单位:解放军总医院心内科和解放军西藏军区总医院心内科.对象:选择272名藏族男性代表藏族人群,年龄(43±9)岁,均为拉萨本地居民.选择580名青藏铁路建设工人代表汉族人群,均为男性,年龄(42±11)岁;均来自四川省;且在拉萨市居住1年以上,同样生活在同一高原地区(拉萨市海拔3 658 m).所有参试者均为2006-02/05在解放军西藏军区总医院进行常规健康体检者,且对检测项目知情同意.方法:①测量身高、体质量、腰围、臀围、收缩压、舒张压,计算体质量指数(体质量/身高2).②肱动脉舒张功能检查:采用GE公司Vivid 7超声仪、10 MHz高频探头扫描右臂肱动脉.先记录肱动脉基础直径,之后将袖带充气至高于受试者收缩压50 mm Hg(1 mm Hg=0.133 kPa)以阻断动脉血流,并保持4 min.在充气状态下及放气后2 min时分别测量肱动脉直径.袖带放气后,血管反应性充血,此时血流量增加以适应前臂阻力血管的扩张.使用计算机辅助软件计算肱动脉直径.肱动脉内皮功能绝对变化和相对变化由Vivid 7超声仪本身附带软件自动计算得出.③生化检查:禁食12 h后,采用日立7600型全自动生化分析仪测定血总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平.④计量资料比较采用方差分析,计数资料采用卡方检验.主要观察指标:比较两组之间的体质量指数、腰臀比、血压、血脂、基础肱动脉直径和肱动脉直径变化.结果:藏族人272名和汉族人580名均进入结果分析.①肱动脉舒张功能:藏族人群基础肱动脉直径明显大于汉族人群[(4.28±0.06),(4.03±0.04)mm,t=71.915 6,P＜0.01],肱动脉绝对及相对变化分别为(0.124±0.005)mm,(2.934±0.204)%,明显小于汉族[(0.141±0.006)mm,(3.587±0.152)%,t=40.582 0,52.173 2,P＜0.01].②体格检查结果:藏族人群体质量指数、腰臀比分别为(30.1±2.5)kg/m2,0.92±0.07,明显大于汉族人群[(26.5±3.4)kg/m2].③血清三酰甘油和低密度脂蛋白胆固醇水平:藏族人群分别为(2.31±1.31),(3.49±0.91)mmol/L,明显高于汉族人群[(1.97±1.44),(3.07±0.86)mmol/L,t=3.420 0,6.5223,P＜0.01].结论:①藏族人群肱动脉舒张功能较汉族人群差,即血管反应性差.②藏族人群腹型肥胖较汉族严重,血脂也较高.
揹景:近年來研究認為內皮功能是動脈粥樣硬化性疾病的新的獨立危險因子,但藏漢兩族人群內皮功能的差異尚未得到充分研究.目的:比較藏漢兩族人群內皮功能的差異,同時比較血脂及肥胖相關指標.設計:對比分析.單位:解放軍總醫院心內科和解放軍西藏軍區總醫院心內科.對象:選擇272名藏族男性代錶藏族人群,年齡(43±9)歲,均為拉薩本地居民.選擇580名青藏鐵路建設工人代錶漢族人群,均為男性,年齡(42±11)歲;均來自四川省;且在拉薩市居住1年以上,同樣生活在同一高原地區(拉薩市海拔3 658 m).所有參試者均為2006-02/05在解放軍西藏軍區總醫院進行常規健康體檢者,且對檢測項目知情同意.方法:①測量身高、體質量、腰圍、臀圍、收縮壓、舒張壓,計算體質量指數(體質量/身高2).②肱動脈舒張功能檢查:採用GE公司Vivid 7超聲儀、10 MHz高頻探頭掃描右臂肱動脈.先記錄肱動脈基礎直徑,之後將袖帶充氣至高于受試者收縮壓50 mm Hg(1 mm Hg=0.133 kPa)以阻斷動脈血流,併保持4 min.在充氣狀態下及放氣後2 min時分彆測量肱動脈直徑.袖帶放氣後,血管反應性充血,此時血流量增加以適應前臂阻力血管的擴張.使用計算機輔助軟件計算肱動脈直徑.肱動脈內皮功能絕對變化和相對變化由Vivid 7超聲儀本身附帶軟件自動計算得齣.③生化檢查:禁食12 h後,採用日立7600型全自動生化分析儀測定血總膽固醇、三酰甘油、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇水平.④計量資料比較採用方差分析,計數資料採用卡方檢驗.主要觀察指標:比較兩組之間的體質量指數、腰臀比、血壓、血脂、基礎肱動脈直徑和肱動脈直徑變化.結果:藏族人272名和漢族人580名均進入結果分析.①肱動脈舒張功能:藏族人群基礎肱動脈直徑明顯大于漢族人群[(4.28±0.06),(4.03±0.04)mm,t=71.915 6,P＜0.01],肱動脈絕對及相對變化分彆為(0.124±0.005)mm,(2.934±0.204)%,明顯小于漢族[(0.141±0.006)mm,(3.587±0.152)%,t=40.582 0,52.173 2,P＜0.01].②體格檢查結果:藏族人群體質量指數、腰臀比分彆為(30.1±2.5)kg/m2,0.92±0.07,明顯大于漢族人群[(26.5±3.4)kg/m2].③血清三酰甘油和低密度脂蛋白膽固醇水平:藏族人群分彆為(2.31±1.31),(3.49±0.91)mmol/L,明顯高于漢族人群[(1.97±1.44),(3.07±0.86)mmol/L,t=3.420 0,6.5223,P＜0.01].結論:①藏族人群肱動脈舒張功能較漢族人群差,即血管反應性差.②藏族人群腹型肥胖較漢族嚴重,血脂也較高.
배경:근년래연구인위내피공능시동맥죽양경화성질병적신적독립위험인자,단장한량족인군내피공능적차이상미득도충분연구.목적:비교장한량족인군내피공능적차이,동시비교혈지급비반상관지표.설계:대비분석.단위:해방군총의원심내과화해방군서장군구총의원심내과.대상:선택272명장족남성대표장족인군,년령(43±9)세,균위랍살본지거민.선택580명청장철로건설공인대표한족인군,균위남성,년령(42±11)세;균래자사천성;차재랍살시거주1년이상,동양생활재동일고원지구(랍살시해발3 658 m).소유삼시자균위2006-02/05재해방군서장군구총의원진행상규건강체검자,차대검측항목지정동의.방법:①측량신고、체질량、요위、둔위、수축압、서장압,계산체질량지수(체질량/신고2).②굉동맥서장공능검사:채용GE공사Vivid 7초성의、10 MHz고빈탐두소묘우비굉동맥.선기록굉동맥기출직경,지후장수대충기지고우수시자수축압50 mm Hg(1 mm Hg=0.133 kPa)이조단동맥혈류,병보지4 min.재충기상태하급방기후2 min시분별측량굉동맥직경.수대방기후,혈관반응성충혈,차시혈류량증가이괄응전비조력혈관적확장.사용계산궤보조연건계산굉동맥직경.굉동맥내피공능절대변화화상대변화유Vivid 7초성의본신부대연건자동계산득출.③생화검사:금식12 h후,채용일립7600형전자동생화분석의측정혈총담고순、삼선감유、고밀도지단백담고순、저밀도지단백담고순수평.④계량자료비교채용방차분석,계수자료채용잡방검험.주요관찰지표:비교량조지간적체질량지수、요둔비、혈압、혈지、기출굉동맥직경화굉동맥직경변화.결과:장족인272명화한족인580명균진입결과분석.①굉동맥서장공능:장족인군기출굉동맥직경명현대우한족인군[(4.28±0.06),(4.03±0.04)mm,t=71.915 6,P＜0.01],굉동맥절대급상대변화분별위(0.124±0.005)mm,(2.934±0.204)%,명현소우한족[(0.141±0.006)mm,(3.587±0.152)%,t=40.582 0,52.173 2,P＜0.01].②체격검사결과:장족인군체질량지수、요둔비분별위(30.1±2.5)kg/m2,0.92±0.07,명현대우한족인군[(26.5±3.4)kg/m2].③혈청삼선감유화저밀도지단백담고순수평:장족인군분별위(2.31±1.31),(3.49±0.91)mmol/L,명현고우한족인군[(1.97±1.44),(3.07±0.86)mmol/L,t=3.420 0,6.5223,P＜0.01].결론:①장족인군굉동맥서장공능교한족인군차,즉혈관반응성차.②장족인군복형비반교한족엄중,혈지야교고.
BACKGROUND: Recently, it is thought that endothelial function is a new independent risk factor of atherosclerotic disease. However, the differences in endothelial function between Tibetan and Han nationality populations have not been fully investigated.OBJ ECTIVE: To investigate the differences in endothelial function between Tibetan and Han nationality population.DESIGN: Controlled analysis.SETTING: Department of Cardiology, General Hospital; Department of Cardiology, Tibet General Hospital of Chinese PLA.PARTICIPANTS: Totally 272 Tibetan male subjects, aged (43±9) years, were enrolled in this study to stand for Tibetan nationality populations. All of them were native residents in Lhasa city. And 580 Qinghai-Tibetan railway constructers with Han nationality, aged (42±11) years, were enrolled in this study to stand for Han nationality populations. All of them were male subjects from Sichuan province and lived in Lhasa city for at least 1 year. All the participants received regular physical examination between February and May 2006 in the General Hospital of Tibet Military Area Command of Chinese PLA. All the subjects lived in the same high-altitude area (the altitude of Lhasa is 3 658 m). Informed consents were obtained from all the participants.METHODS: ①Height, body mass, waist circumference, hip circumference, systolic blood pressure(SBP) and diastolic blood pressure (DBP) were measured. Body mass index (BMI) was measured as body mass/height2. ② Measurement of brachial artery flow-mediated dilation (FMD): All the participants, who were in the fasting state, were examined in supine position following 20-minute rest. The room temperature was about 20 ℃. In the right arm, a sphygmomanometer cuff was positioned 5 cm below the antecubital fossa. A 10-MHz transducer (Vivid 7, GE Corporation, USA) was used to image the right brachial artery. After obtaining the baseline imaging, the blood pressure cuff was inflated 50 mm Hg (1 mm Hg=0.133 kPa) above the participant's SBP to occlude the brachial artery for 4 minutes. The brachial artery was then imaged during cuff inflation and 2 minutes after cuff release. After the cuff was released and reactive hyperaemia occurred, that was, flow in the brachial artery increased to accommodate the dilated resistance vessels in the forearm. In order to ensure the reliability of the data, the cuff placement and image record were performed by two designated performers. Computer-assisted analysis software was used to calculate brachial artery diameters. The absolute and relative changes of brachial artery FMD were automatically calculated out with the attached software of Vivid 7 ultrasonic diagnosis instrument. ③Biochemical study: The biochemical parameters were obtained after an overnight fasting for 12 hours. Venous blood was sampled for the measurement of total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (LDL-C). ④ Analysis of variance was used to evaluate the measurement data. Chi-square statistic was used to compare enumeration data.MAIN OUTCOME MEASURES: Comparison of change in BMI, waist-hip ratio, blood pressure, blood lipid, baseline brachial diameter and brachial diameter between 2 groups.RESULTS: Totally 272 Tibetan nationality populations and 583 Han nationality populations participated in the final analysis. ① Brachial artery FMD: The baseline brachial artery diameter of Tibetan nationality populations was significantly larger than that of Han nationality population [(4.28±0.06) mm vs. (4.03±0.04) mm, t =71.915 6, P ＜0.01]; The absolute and relative changes of brachial artery of Tibetan nationality populations were significantly smaller than those of Han nationality populations, respectively [(0.124±0.005) mm vs. (0.141±0.006) mm; (2.934±0.204)% vs.(3.587±0.152)%, t = 40.582 0,52.173 2, P ＜ 0.01]. ②Physical study results: BMI and waist-hip ratio of Tibetan nationality populations were significantly larger than those of Han nationality populations [(30.1±2.5) kg/m2 vs. (26.5±3.4) kg/m2, 0.92±0.07 vs. 0.88±0.05, t =15.595 1, 9.525 4, P ＜ 0.01]. ③TG and LDL-C levels of Tibetan nationality population were (2.31±1.31) mmol/L and (3.49±0.91) mmol/L, respectively, which were significantly higler than those of Han nationality population [(1.97±1.44) mmol/L and (3.07±0.86) mmol/L, t =3.420 0, 6.522 3, P ＜ 0.01].CONCLUSION: ① Brachial artery FMD of Tibetan nationality population is poorer than that of Han nationality population,I.e. Poor vascular reactivity. ② Tibetan nationality populations have severe abdominal obesity and higher level of blood lipid as compared with Han nationality populations.
