中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2009年
9期
910-913
,共4页
沈琪%薛冰%郝长宁%丁东新%石一沁%高兴旺
瀋琪%薛冰%郝長寧%丁東新%石一沁%高興旺
침기%설빙%학장저%정동신%석일심%고흥왕
脉压%老年人%动脉粥样硬化%靶器官损害
脈壓%老年人%動脈粥樣硬化%靶器官損害
맥압%노년인%동맥죽양경화%파기관손해
Pulse pressure%Eider%Artery atherosclerosis%Target organ damage
目的 探讨老年人脉压与动脉粥样硬化的关系.方法 以杨浦区中心医院及杨浦区11个街道社区卫生服务中心随访的老年人为对象,选取年龄>160岁患有动脉粥样硬化危险因素的患者2358人,记录入选者的基本情况:年龄、性别、身高、体重、吸烟史,血压、心率、冠心病、缺血性脑卒中、慢性肾脏病、糖尿病等病史.测定空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血肌酐、尿酸、丙氨酸氨基转移酶.根据脉压将入选者分为脉压<60 mm Hg组和≥60 mm Hg组.分析2组脉压与年龄、体重指数、收缩压、舒张压、心率、空腹血糖、血脂、血肌酐、尿酸、丙氨酸氨基转移酶、肌酐清除率、冠心痛、缺血性脑卒中、慢性肾脏病、糖尿病等关系.结果 脉压≥60 mm Hg组与脉压<60 mm Hg组比较,血糖[(6.3±2.6)mmol/L与(5.6±1.7)mmol/L]、总胆固醇[(4.8±1.2)mmol/L与(4.3±1.3)mmol/L]、甘油三酯[(1.9±1.1)mmol/L与(1.5±1.2)mmol/L]、低密度脂蛋白胆固醇[(2.9±1.2)mmoL/L与(2.5±1.1)mmol/L]、尿酸[(291.4±133.6)μmol/L与(246.8±131.2)μmoL/L]均明显升高(P均<0.01).脉压≥60mm Hg组与脉压<60 mm Hg组比较,冠心病(17.8%与10.8%)、缺血性脑卒中(31.7%与26.0%)、慢性肾脏病(16.9%与12.4%)、糖尿病(23.8%与17.6%)患病率均明显升高(P均<0.01).Logostic多元线性逐步回归分析结果 显示脉压与血糖、体重指数、年龄、低密度脂蛋白胆固醇、尿酸、高密度脂蛋白胆固醇密切相关(β分别为0.103、0.093、0.097、0.089、0.076、-0.057,P均<0.05).结论 有动脉粥样硬化基础的老年人,脉压高可促进动脉粥样硬化的发展,促进心脑血管及肾脏疾病的发生、发展.
目的 探討老年人脈壓與動脈粥樣硬化的關繫.方法 以楊浦區中心醫院及楊浦區11箇街道社區衛生服務中心隨訪的老年人為對象,選取年齡>160歲患有動脈粥樣硬化危險因素的患者2358人,記錄入選者的基本情況:年齡、性彆、身高、體重、吸煙史,血壓、心率、冠心病、缺血性腦卒中、慢性腎髒病、糖尿病等病史.測定空腹血糖、總膽固醇、甘油三酯、低密度脂蛋白膽固醇、高密度脂蛋白膽固醇、血肌酐、尿痠、丙氨痠氨基轉移酶.根據脈壓將入選者分為脈壓<60 mm Hg組和≥60 mm Hg組.分析2組脈壓與年齡、體重指數、收縮壓、舒張壓、心率、空腹血糖、血脂、血肌酐、尿痠、丙氨痠氨基轉移酶、肌酐清除率、冠心痛、缺血性腦卒中、慢性腎髒病、糖尿病等關繫.結果 脈壓≥60 mm Hg組與脈壓<60 mm Hg組比較,血糖[(6.3±2.6)mmol/L與(5.6±1.7)mmol/L]、總膽固醇[(4.8±1.2)mmol/L與(4.3±1.3)mmol/L]、甘油三酯[(1.9±1.1)mmol/L與(1.5±1.2)mmol/L]、低密度脂蛋白膽固醇[(2.9±1.2)mmoL/L與(2.5±1.1)mmol/L]、尿痠[(291.4±133.6)μmol/L與(246.8±131.2)μmoL/L]均明顯升高(P均<0.01).脈壓≥60mm Hg組與脈壓<60 mm Hg組比較,冠心病(17.8%與10.8%)、缺血性腦卒中(31.7%與26.0%)、慢性腎髒病(16.9%與12.4%)、糖尿病(23.8%與17.6%)患病率均明顯升高(P均<0.01).Logostic多元線性逐步迴歸分析結果 顯示脈壓與血糖、體重指數、年齡、低密度脂蛋白膽固醇、尿痠、高密度脂蛋白膽固醇密切相關(β分彆為0.103、0.093、0.097、0.089、0.076、-0.057,P均<0.05).結論 有動脈粥樣硬化基礎的老年人,脈壓高可促進動脈粥樣硬化的髮展,促進心腦血管及腎髒疾病的髮生、髮展.
목적 탐토노년인맥압여동맥죽양경화적관계.방법 이양포구중심의원급양포구11개가도사구위생복무중심수방적노년인위대상,선취년령>160세환유동맥죽양경화위험인소적환자2358인,기록입선자적기본정황:년령、성별、신고、체중、흡연사,혈압、심솔、관심병、결혈성뇌졸중、만성신장병、당뇨병등병사.측정공복혈당、총담고순、감유삼지、저밀도지단백담고순、고밀도지단백담고순、혈기항、뇨산、병안산안기전이매.근거맥압장입선자분위맥압<60 mm Hg조화≥60 mm Hg조.분석2조맥압여년령、체중지수、수축압、서장압、심솔、공복혈당、혈지、혈기항、뇨산、병안산안기전이매、기항청제솔、관심통、결혈성뇌졸중、만성신장병、당뇨병등관계.결과 맥압≥60 mm Hg조여맥압<60 mm Hg조비교,혈당[(6.3±2.6)mmol/L여(5.6±1.7)mmol/L]、총담고순[(4.8±1.2)mmol/L여(4.3±1.3)mmol/L]、감유삼지[(1.9±1.1)mmol/L여(1.5±1.2)mmol/L]、저밀도지단백담고순[(2.9±1.2)mmoL/L여(2.5±1.1)mmol/L]、뇨산[(291.4±133.6)μmol/L여(246.8±131.2)μmoL/L]균명현승고(P균<0.01).맥압≥60mm Hg조여맥압<60 mm Hg조비교,관심병(17.8%여10.8%)、결혈성뇌졸중(31.7%여26.0%)、만성신장병(16.9%여12.4%)、당뇨병(23.8%여17.6%)환병솔균명현승고(P균<0.01).Logostic다원선성축보회귀분석결과 현시맥압여혈당、체중지수、년령、저밀도지단백담고순、뇨산、고밀도지단백담고순밀절상관(β분별위0.103、0.093、0.097、0.089、0.076、-0.057,P균<0.05).결론 유동맥죽양경화기출적노년인,맥압고가촉진동맥죽양경화적발전,촉진심뇌혈관급신장질병적발생、발전.
Objective To explore the relationship between pulse pressure (PP) and artery atherosclerosis in elders. Methods Totally 2358 eiders( > 60y) with the risk factors of artery atherosclerosis from Yangpu District DOI:10.3760/cma.j.issn.1008-6315.2009.09.006Central Hospital and 11 Community Health Service Centers were enrolled . The basic information includes age, sex, height,body mass, history of smoking, blood pressure, heart rate, history of coronary heart disease, ischemic stoke, chronic kidney diseases and diabetes,etc. The fasting blood sugar(FBS) ,blood lipid( total cholesterel,triglyceride, low-density lipreprotein, high-deusity liproprotein), serum creatinine, serum uric acid, serum alanine aminotransferase were measured. The elders were divided into two groups according to the PP( PP <60 mm Hg and PP≥60 mm Hg) to analyse the relationship between PP and age, BMI, SBP, DBP, HR, FBS, TC, TG, LDL-C, HDL-C, Cr, Ccr, UA, AST and history of coronary heart disease,ischemic stoke,chronic renal disease, and diabetes. Results Serum levels of FBS,TC,TG, LDL-C, UA in the group with PP less than 60 nun Hg were ( 5.6±1.7 ) mmol/L, (4.3±1.3 ) mmol/L, ( 1.5±1.2) mmol/L, ( 2.5±1.1 ) mmol/L, UA ( 246.8±131.2 ) μmol/L, that in the group with PP over or equal to 60 mm Hg group were (6.3±2.6) mmol/L, (4.8±1.2) mmol/L, ( 1.9±1.1 ) mmol/L, (2.9±1.2) mmol/L, (291.4±133.6) μmol/L, Serum levels of FBS, TC, TG, LDL-C, UA in the group with PP over 60 mm Hg were obviously elevated as compared with that in the group with PP lower than 60 ram Hg(P <0.01 ) ; The preven-lence rates of coronary heart disease ischemic stoke,chronic,renal disease, diabetes in the group with PP less than 60 mm Hg were 10.8% ,26.0%, 12.4%, 17.6%, that in the group with PP over or equal to 60 mm Hg group were 17.8% 、31.7% ,16.9% ,23.8% (P <0.01 ). The preveulence of coronary heart disease ischemic stoke,chronic re-nal disease, diabetes were significandy increased in the group with PP over or equal to 60 mm Hg group. Logistic re-gression analysis showed PP was closely related to FBS, BMI, age, LDL-C, UA, HDL-C ( β = 0.103,0.093.0.097, 0.089 ,0.076 , - 0.057, P < 0.05 ). Conclusions For those elders with the basis of artery atherosclerosis, high PP can inhance the development of artery atheresclerosis and also inhance the occurance and development of cardio-ce-rebrovascular and renal diseases.
