中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
5期
476-480
,共5页
党连生%刘美玲%徐燕%刘少旋%宫武装%朱王亮
黨連生%劉美玲%徐燕%劉少鏇%宮武裝%硃王亮
당련생%류미령%서연%류소선%궁무장%주왕량
脉搏波传导速度%老年人%危险因素
脈搏波傳導速度%老年人%危險因素
맥박파전도속도%노년인%위험인소
Pulse wave velocity%Elderly%Risk factors
目的 探讨肱-踝脉搏波传导速度(baPWV)与心血管病危险因素的关系,为临床早期检测动脉硬化提供新途径.方法 选择2010年11月至2011年10月于我院体检或住院的老年人共348例作为研究对象,其中男232例,女116例；平均年龄(74.5±9.0)岁.所有对象均接受问卷调查,记录病史,并测定baPWV,同时测量身高、体质量、腰围、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等指标.比较危险因素与baPWV的关系.结果 (1)心血管危险因素数量越多,baPWV升高发生率越高.(2)多因素Logistic回归分析显示:年龄(OR=5.223,95％CI:3.606 ～7.564)、LDL-C升高(OR=4.554,95％ CI:2.413 ～8.593)、吸烟(OR=6.007,95％ CI:3.775～9.560)、肥胖(OR=3.019,95％ CI:2.363 ～3.857)、高血压(OR=6.938,95％ CI:3.591 ～13.404)、高盐饮食(OR=2.555,95％ CI:2.108～3.096)是baPWV升高的独立危险因素(P均＜0.05)；运动(OR =0.941,95％ CI0.915 ～0.967)、睡眠(OR=0.947,95％ CI0.927 ～0.968)是baPWV升高的保护因素(P均＜0.05).(3)按照运动时间将健康组分为运动组(运动时间≥1 h/d)和少运动组(运动时间＜1 h/d),按照是否失眠分失眠组和无失眠组,发现运动组的baPWV值明显低于少运动组[分别为:(1169.0±34.8)、(1370.0±51.7) cm/s,t =2.719,P=0.012],无失眠组的baPWV值明显低于失眠组[分别为:( 1205.0 ±29.4)、( 1358.0±36.2) cm/s,t =2.561,P=0.017],差异有统计学意义.(4)老年单纯高血压组baPWV为(1852.0±46.7) cm/s、糖尿病组baPWV为(1693.0±38.2) cm/s、冠心病组baPWV为( 1729.0±40.4)cm/s,较健康组[baPWV为(1356.0±31.3) cm/s]高,差异均有统计学意义(P均＜0.05).但单纯高血压组和高血压合并脑梗死组、单纯冠心病组和冠心病心肌梗死组baPWV差异均无统计学意义.结论 (1)年龄、LDL-C升高、吸烟、肥胖、高血压、高盐饮食是baPWV升高的独立危险因素；运动、良好的睡眠是baPWV升高的保护性因素.(2)baPWV检测可做为发现早期动脉僵硬度增高的手段之一.
目的 探討肱-踝脈搏波傳導速度(baPWV)與心血管病危險因素的關繫,為臨床早期檢測動脈硬化提供新途徑.方法 選擇2010年11月至2011年10月于我院體檢或住院的老年人共348例作為研究對象,其中男232例,女116例；平均年齡(74.5±9.0)歲.所有對象均接受問捲調查,記錄病史,併測定baPWV,同時測量身高、體質量、腰圍、甘油三酯(TG)、總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)等指標.比較危險因素與baPWV的關繫.結果 (1)心血管危險因素數量越多,baPWV升高髮生率越高.(2)多因素Logistic迴歸分析顯示:年齡(OR=5.223,95％CI:3.606 ～7.564)、LDL-C升高(OR=4.554,95％ CI:2.413 ～8.593)、吸煙(OR=6.007,95％ CI:3.775～9.560)、肥胖(OR=3.019,95％ CI:2.363 ～3.857)、高血壓(OR=6.938,95％ CI:3.591 ～13.404)、高鹽飲食(OR=2.555,95％ CI:2.108～3.096)是baPWV升高的獨立危險因素(P均＜0.05)；運動(OR =0.941,95％ CI0.915 ～0.967)、睡眠(OR=0.947,95％ CI0.927 ～0.968)是baPWV升高的保護因素(P均＜0.05).(3)按照運動時間將健康組分為運動組(運動時間≥1 h/d)和少運動組(運動時間＜1 h/d),按照是否失眠分失眠組和無失眠組,髮現運動組的baPWV值明顯低于少運動組[分彆為:(1169.0±34.8)、(1370.0±51.7) cm/s,t =2.719,P=0.012],無失眠組的baPWV值明顯低于失眠組[分彆為:( 1205.0 ±29.4)、( 1358.0±36.2) cm/s,t =2.561,P=0.017],差異有統計學意義.(4)老年單純高血壓組baPWV為(1852.0±46.7) cm/s、糖尿病組baPWV為(1693.0±38.2) cm/s、冠心病組baPWV為( 1729.0±40.4)cm/s,較健康組[baPWV為(1356.0±31.3) cm/s]高,差異均有統計學意義(P均＜0.05).但單純高血壓組和高血壓閤併腦梗死組、單純冠心病組和冠心病心肌梗死組baPWV差異均無統計學意義.結論 (1)年齡、LDL-C升高、吸煙、肥胖、高血壓、高鹽飲食是baPWV升高的獨立危險因素；運動、良好的睡眠是baPWV升高的保護性因素.(2)baPWV檢測可做為髮現早期動脈僵硬度增高的手段之一.
목적 탐토굉-과맥박파전도속도(baPWV)여심혈관병위험인소적관계,위림상조기검측동맥경화제공신도경.방법 선택2010년11월지2011년10월우아원체검혹주원적노년인공348례작위연구대상,기중남232례,녀116례；평균년령(74.5±9.0)세.소유대상균접수문권조사,기록병사,병측정baPWV,동시측량신고、체질량、요위、감유삼지(TG)、총담고순(TC)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)등지표.비교위험인소여baPWV적관계.결과 (1)심혈관위험인소수량월다,baPWV승고발생솔월고.(2)다인소Logistic회귀분석현시:년령(OR=5.223,95％CI:3.606 ～7.564)、LDL-C승고(OR=4.554,95％ CI:2.413 ～8.593)、흡연(OR=6.007,95％ CI:3.775～9.560)、비반(OR=3.019,95％ CI:2.363 ～3.857)、고혈압(OR=6.938,95％ CI:3.591 ～13.404)、고염음식(OR=2.555,95％ CI:2.108～3.096)시baPWV승고적독립위험인소(P균＜0.05)；운동(OR =0.941,95％ CI0.915 ～0.967)、수면(OR=0.947,95％ CI0.927 ～0.968)시baPWV승고적보호인소(P균＜0.05).(3)안조운동시간장건강조분위운동조(운동시간≥1 h/d)화소운동조(운동시간＜1 h/d),안조시부실면분실면조화무실면조,발현운동조적baPWV치명현저우소운동조[분별위:(1169.0±34.8)、(1370.0±51.7) cm/s,t =2.719,P=0.012],무실면조적baPWV치명현저우실면조[분별위:( 1205.0 ±29.4)、( 1358.0±36.2) cm/s,t =2.561,P=0.017],차이유통계학의의.(4)노년단순고혈압조baPWV위(1852.0±46.7) cm/s、당뇨병조baPWV위(1693.0±38.2) cm/s、관심병조baPWV위( 1729.0±40.4)cm/s,교건강조[baPWV위(1356.0±31.3) cm/s]고,차이균유통계학의의(P균＜0.05).단단순고혈압조화고혈압합병뇌경사조、단순관심병조화관심병심기경사조baPWV차이균무통계학의의.결론 (1)년령、LDL-C승고、흡연、비반、고혈압、고염음식시baPWV승고적독립위험인소；운동、량호적수면시baPWV승고적보호성인소.(2)baPWV검측가주위발현조기동맥강경도증고적수단지일.
Objective To investigate the relationship between atherosclerosis and cardiovascular risk factors in the elderly,thus to provide new method for detection of atherosclerosis in the elderly.Methods From November 2010 to October 2011,348 elderly who addmitted to or had physical examination in our hospital were recruited in the study.All participants were interviewed through questionnaire,and medical history was recorded,Brachial-ankle pulse wave velocity (baPWV) was measured.Simultaneously,height,body weight,waist circumferrence,triglyceride ( TG ),total cholesterol ( TC ),high density lipoprotein-cholesterol ( HDL-C ),low density lipoprotein-cholesterol(LDL-C) were measured.The association between baPWV and cardiovascular and atherosclerosis was investigated.Results The incidence of higher baPWV was increasing as the number of risk factors of cardio vascular disease adding.Logistic regression analysis show that:Age ( OR =5.223,95％ CI 3.606 -7.564),LDL-C( OR =4.554,95％ CI 2.413 - 8.593 ),Smoking ( OR =6.007,95％ CI 3.775 - 9.560),Obesity( OR =3.019,95 ％ CI 2.363 - 3.857 ),Hypertension ( OR =6.938,95％ CI 3.591 - 13.404 ),High-salt diet( OR =2.555,95％ CI 2.108 -3.096)were independent risk factors of baPWV increase (P ＜0.05); Exercise and good sleep were the protective factors for baPWV increasing.BaPWV levels were significantly lower in the exercise group (exercise time ＞ 1 h/d)than in the few exercise group (exercise time ＜ 1h/d) (t =2.719,P =0.012 ),and lower in good sleep group participants than in insomnia participants (t =2.561,P =0.017 ) (P ＜ 0.05 ).BaPWV levels were significantly higherin the group with essential hypertension ( 1852.0 ± 46.7 cm/s),with Type 2 Diabetes Mellitus ( 1693.0 ± 38.2 cm/s),with coronary heart disease ( 1729.0 ± 40.4 cm/s) than in the healthy group ( 1356.0 ± 3 1.3 cm/s) ( P ＜ 0.05 ).There was no statistical difference between the essential hypertension group and the hypertension complicated with cerebral infarction group,as well as between the coronary heart disease group and the myocardial infarction group.Conclusion Age,LDL-C increasing,smoking,obesity,hypertension and high-salt diet were independent risk factors of baPWV increase;Exercise and good sleep were protective factors.BaPWV could be one of the methods for early detection of atherosclerosis.
