CAJ | 학술논문

目的分析高血压患者高危和很高危心血管病(CVD)危险度与踝臂指数(ABI)异常的关联性,探讨根据CVD危险度防治下肢动脉疾病的措施.方法 2008年12月至2009年5月,现况调查我国18个研究中心入选的2674例40岁以上无冠心病、卒中/短暂性脑缺血发作或动脉硬化临床症状的原发性高血压患者的ABI异常(ABI ＜0.90)情况,并收集病史、体格检查和实验室检查资料.结果分析有效例数为2615例.高危与很高危组高血压患者的ABI异常率均有随年龄增长而增高的趋势(P＜0.001).与高危组相比,很高危组的60～岁(1.3％比5.1％)和70～岁年龄组(4.1％比10.5％)的ABI异常率较高(P＜0.05).校正一定因素(研究中心、靶器官损害、CVD危险因素和人口学因素),拟合CVD危险度与ABI异常关系的非条件Logistic回归模型表明,二者间有正相关关系(OR=1.874,95％ CI 1.153 ～3.045,P=0.0112),很高危高血压患者发生ABI异常的可能性是高危者的1.874倍.结论高危高血压患者的CVD危险度越高,发生ABI异常的可能性越大.该正相关效应在60～岁和70～岁年龄段的高危高血压患者中尤为明显.
목적 분석고혈압환자고위화흔고위심혈관병(CVD)위험도여과비지수(ABI)이상적관련성,탐토근거CVD위험도방치하지동맥질병적조시.방법 2008년12월지2009년5월,현황조사아국18개연구중심입선적2674례40세이상무관심병、졸중/단잠성뇌결혈발작혹동맥경화림상증상적원발성고혈압환자적ABI이상(ABI ＜0.90)정황,병수집병사、체격검사화실험실검사자료.결과 분석유효례수위2615례.고위여흔고위조고혈압환자적ABI이상솔균유수년령증장이증고적추세(P＜0.001).여고위조상비,흔고위조적60～세(1.3％비5.1％)화70～세년령조(4.1％비10.5％)적ABI이상솔교고(P＜0.05).교정일정인소(연구중심、파기관손해、CVD위험인소화인구학인소),의합CVD위험도여ABI이상관계적비조건Logistic회귀모형표명,이자간유정상관관계(OR=1.874,95％ CI 1.153 ～3.045,P=0.0112),흔고위고혈압환자발생ABI이상적가능성시고위자적1.874배.결론 고위고혈압환자적CVD위험도월고,발생ABI이상적가능성월대.해정상관효응재60～세화70～세년령단적고위고혈압환자중우위명현.
Objective To evaluate the relevance of cardiovascular disease (CVD) risk and abnormal ankle brachial index (ABI) in high-risk and very high-risk hypertensive patients and explore the strategies of prevention and treatment for peripheral arterial disease according to the CVD risk.Methods Between December 2008 and May 2009,the cross-sectional study investigated the prevalence of abnormal ABI (ABI ＜0.90) in 2674 community-dwelling,hypertensive patients,aged ≥40 years old,without coronary heart disease,stroke/transient ischemic attack or known arteriosclerosis,from 18 centers in China.The relevant data were acquired through history,physical examination,laboratory examinations and other diagnostic tests.Results The number of subjects available for the full-analysis set was 2615.There was a rising prevalence of abnormal ABI with the advancing age in high-risk hypertensive patients and very highrisk ones (P＜0.001 ).Compared with the high-risk group,the 60 years ( 1.3％ vs 5.1％ ) and 70 years (4.1％ vs 10.5％ ) age sub-groups of the very high-risk group had a significantly higher prevalence of abnormal ABI (P ＜0.05 ).After adjusting for such factors as investigational center,target organ damage,CVD risk and demographics,an unconditional Logistic regression model revealed that CVD risk was positively correlated with abnormal ABI ( odds ratio 1.874,95％ confidence interval 1.153 - 3.045,P =0.0112).A very high-risk hypertensive patient was 1.874 times more likely than a high-risk one to have an abnormal ABI.Conclusion A high-risk hypertensive patient with a higher CVD risk is more prone to have an abnormal ABI.Among the high-risk hypertensive patients in the 60 years and 70 years age sub-groups,such a positive correlation is especially pronounced.