CAJ | 학술논문

目的探讨正常高值血压、血脂和血糖人群的动脉弹性特点及其影响因素.方法从2008年3月至2009年12月从北京、重庆社区12899例自然人群中筛选出正常高值血压者65例、高值血脂者156例、高值血糖者159例、正常高值(血压+血脂)者85例、正常高值(血压+血糖)者77例、正常高值(血脂+血糖)者55例、正常高值(血压+血脂+血糖)者9例.另将健康者332名、高血压患者113例、高脂血症患者150例及糖尿病患者37例作为对照.采用Dynapulse 200 M动脉弹性仪测定系统血管顺应性(SVC)、系统血管阻力(SVR)和肱动脉扩张性(BAD).结果 (1)高值血压者的SVC低于健康者[(1.14 ±0.20) ml比(1.26±0.23) ml,P＜0.01],高于高血压患者[(1.11 ±0.18)ml,P=0.011]；SVR高于健康者[(157±29) kPa· s·L-1比(148±25)kPa·s·L-1,P=0.012),低于高血压患者[(166±36)kPa·s·L-1,P＜0.01]；BAD低于健康者(5.93％±1.14％比6.50％±1.30％,P＜0.01).(2)不同正常高值亚组间的SVC、SVR、BAD差异均有统计学意义(均P＜0.05).(3)多元线性回归分析显示,血压是血管功能的独立危险因素.结论血压正常高值阶段时,血管功能已经损害,血压是影响血管功能的独立危险因素.多种心血管危险因素在正常高值阶段的聚集对血管功能的影响更大.
목적 탐토정상고치혈압、혈지화혈당인군적동맥탄성특점급기영향인소.방법 종2008년3월지2009년12월종북경、중경사구12899례자연인군중사선출정상고치혈압자65례、고치혈지자156례、고치혈당자159례、정상고치(혈압+혈지)자85례、정상고치(혈압+혈당)자77례、정상고치(혈지+혈당)자55례、정상고치(혈압+혈지+혈당)자9례.령장건강자332명、고혈압환자113례、고지혈증환자150례급당뇨병환자37례작위대조.채용Dynapulse 200 M동맥탄성의측정계통혈관순응성(SVC)、계통혈관조력(SVR)화굉동맥확장성(BAD).결과 (1)고치혈압자적SVC저우건강자[(1.14 ±0.20) ml비(1.26±0.23) ml,P＜0.01],고우고혈압환자[(1.11 ±0.18)ml,P=0.011]；SVR고우건강자[(157±29) kPa· s·L-1비(148±25)kPa·s·L-1,P=0.012),저우고혈압환자[(166±36)kPa·s·L-1,P＜0.01]；BAD저우건강자(5.93％±1.14％비6.50％±1.30％,P＜0.01).(2)불동정상고치아조간적SVC、SVR、BAD차이균유통계학의의(균P＜0.05).(3)다원선성회귀분석현시,혈압시혈관공능적독립위험인소.결론 혈압정상고치계단시,혈관공능이경손해,혈압시영향혈관공능적독립위험인소.다충심혈관위험인소재정상고치계단적취집대혈관공능적영향경대.
Objective To explore the characteristics and related risk factors of arterial elasticity in persons with prehypertension,high-normal blood lipid and(or) impaired glucose regulation(impaired fasting glucose and (or) impaired glucose tolerance).Methods After receiving physical and biochemical examinations,a total of 1238 persons were enrolled.Among them,the etiologies were prehypertension (n =65),high-normal blood lipid (n=156),impaired glucose regulation (n =159),prehypertension and highnormal blood lipid (n =85),prehypertension and impaired glucose regulation (n =77),high-normal blood lipid and impaired glucose regulation (n =55) and prehypertension,high-normal blood lipid and impaired glucose regulation (n =9).Also 332 healthy subjects,113 hypertensive patients,150 hyperlipidemics and 37 diabetics were enrolled as controls.Systemic vascular compliance (SVC),systemic vascular resistance (SVR),brachial artery distensibility (BAD) were measured with Dynapulse 200 M (Pulse Metric,Inc.,USA).Results In persons with prehypertension,SVC was lower than healty group((1.14 ±0.20) ml vs (1.26 ± 0.23) ml,P ＜ 0.01) and higher than hypertensive group ((1.11 ± 0.18) ml,P =0.011),SVR higher than healty group (157 ± 29) kPa · s · L-1 vs (148 ± 25) kPa · s · L-1,P =0.012) and lower than hypertensive group((166 ± 36) kPa · s · L-1,P ＜ 0.01) and BAD lower than healty group (5.93％ ± 1.14％ vs 6.50％ ± 1.30％,P ＜ 0.01).Among different groups with prehypertension,high-normal blood lipid and(or) impaired glucose regulation,SVC,SVR and BAD had significant differences.As indicated by multiple linear regression analysis,blood pressure was an independent risk factor of arterial elasticity.Conclusions Vascular function becomes damaged in prehypertensive stage.As an independent risk factor,blood pressure had more potent effect than lipid and blood glucose.Multiple cardiovascular risk factors with high-normal value may affect vascular function more strongly.