中国体育科技
中國體育科技
중국체육과기
China Sport Science and Technology
2011年
4期
91~94
,共null页
黄晖明 陶宏军 李森 许浩
黃暉明 陶宏軍 李森 許浩
황휘명 도굉군 리삼 허호
脉搏波传导速度 体质 综合评价 应用
脈搏波傳導速度 體質 綜閤評價 應用
맥박파전도속도 체질 종합평개 응용
pulse wave velocity; physical fitness; integrated evaluation; application
目的:基于脉搏波传导速度(PWV)与血压、超重和肥胖等形态、机能指标相关性研究,探讨PWV在体质综合评价中的应用价值。方法:回顾性研究,在常规体质检测基础上,测量4下文522例普通居民肱踝脉搏波传导速度(baPWV)评价动脉僵硬度。主要处理方法:1)通过血压各指标对baPWV评价的动脉硬化受试者工作(ROC)曲线、高血压和动脉硬化阳性率一致性Kappa检验等分析血压和baPWV相关性;2)logistic逐步回归(校正年龄、性别、高血压)分析超重、肥胖与baPWV关系,根据ROC曲线计算BMI预测动脉硬化的最佳切点。结果:1)江苏人群男性baPWV均值为1 383±237 cm/s,女性1 278±246 cm/s;baP-WV随着年龄增加而增高;2)高血压、正常高值血压人群的baPWV均高于正常人;控制年龄和性别因素,收缩压、舒张压、脉压与PWV均呈显著正相关,动脉硬化ROC曲线均有较好的预测价值,P〈0.001;但是高血压和动脉硬化阳性诊断一致性检验Kappa系数=0.402,以高血压的诊断标准区分人群预测动脉硬化灵敏度只有36%,特异度较高为97.8%;3)超重、肥胖人群baPWV、动脉硬化发生率均显著高于正常者,P〈0.001;校正年龄、性别、血压因素后,超重和肥胖人群动脉硬化OR值分别为1.58和2.1;BMI预测动脉硬化的最佳切点为24.25,此时灵敏度为67.2%,特异度为57.2%。结论:1)baPWV随着年龄增加而增高,且男性高于女性;2)血压指标预测PWV评价的动脉硬化有较高价值,但高血压标准区分人群将漏诊很大部分血压正常、动脉僵硬度却异常者,单纯使用血压指标不能理想地适用于普通人群血管病变的早期风险评估。超重、肥胖人群baPWV和动脉硬化风险显著高于正常者,BMI预测动脉硬化最佳切点为24.25,进一步验证了以24作为BMI超重切点适应性较好;3)PWV和血压等指标一起引入综合体质测评体系有利于对普通人群进行心血管疾病早期风险评估及干预,提高体质测评与健康关联性。
目的:基于脈搏波傳導速度(PWV)與血壓、超重和肥胖等形態、機能指標相關性研究,探討PWV在體質綜閤評價中的應用價值。方法:迴顧性研究,在常規體質檢測基礎上,測量4下文522例普通居民肱踝脈搏波傳導速度(baPWV)評價動脈僵硬度。主要處理方法:1)通過血壓各指標對baPWV評價的動脈硬化受試者工作(ROC)麯線、高血壓和動脈硬化暘性率一緻性Kappa檢驗等分析血壓和baPWV相關性;2)logistic逐步迴歸(校正年齡、性彆、高血壓)分析超重、肥胖與baPWV關繫,根據ROC麯線計算BMI預測動脈硬化的最佳切點。結果:1)江囌人群男性baPWV均值為1 383±237 cm/s,女性1 278±246 cm/s;baP-WV隨著年齡增加而增高;2)高血壓、正常高值血壓人群的baPWV均高于正常人;控製年齡和性彆因素,收縮壓、舒張壓、脈壓與PWV均呈顯著正相關,動脈硬化ROC麯線均有較好的預測價值,P〈0.001;但是高血壓和動脈硬化暘性診斷一緻性檢驗Kappa繫數=0.402,以高血壓的診斷標準區分人群預測動脈硬化靈敏度隻有36%,特異度較高為97.8%;3)超重、肥胖人群baPWV、動脈硬化髮生率均顯著高于正常者,P〈0.001;校正年齡、性彆、血壓因素後,超重和肥胖人群動脈硬化OR值分彆為1.58和2.1;BMI預測動脈硬化的最佳切點為24.25,此時靈敏度為67.2%,特異度為57.2%。結論:1)baPWV隨著年齡增加而增高,且男性高于女性;2)血壓指標預測PWV評價的動脈硬化有較高價值,但高血壓標準區分人群將漏診很大部分血壓正常、動脈僵硬度卻異常者,單純使用血壓指標不能理想地適用于普通人群血管病變的早期風險評估。超重、肥胖人群baPWV和動脈硬化風險顯著高于正常者,BMI預測動脈硬化最佳切點為24.25,進一步驗證瞭以24作為BMI超重切點適應性較好;3)PWV和血壓等指標一起引入綜閤體質測評體繫有利于對普通人群進行心血管疾病早期風險評估及榦預,提高體質測評與健康關聯性。
목적:기우맥박파전도속도(PWV)여혈압、초중화비반등형태、궤능지표상관성연구,탐토PWV재체질종합평개중적응용개치。방법:회고성연구,재상규체질검측기출상,측량4하문522례보통거민굉과맥박파전도속도(baPWV)평개동맥강경도。주요처리방법:1)통과혈압각지표대baPWV평개적동맥경화수시자공작(ROC)곡선、고혈압화동맥경화양성솔일치성Kappa검험등분석혈압화baPWV상관성;2)logistic축보회귀(교정년령、성별、고혈압)분석초중、비반여baPWV관계,근거ROC곡선계산BMI예측동맥경화적최가절점。결과:1)강소인군남성baPWV균치위1 383±237 cm/s,녀성1 278±246 cm/s;baP-WV수착년령증가이증고;2)고혈압、정상고치혈압인군적baPWV균고우정상인;공제년령화성별인소,수축압、서장압、맥압여PWV균정현저정상관,동맥경화ROC곡선균유교호적예측개치,P〈0.001;단시고혈압화동맥경화양성진단일치성검험Kappa계수=0.402,이고혈압적진단표준구분인군예측동맥경화령민도지유36%,특이도교고위97.8%;3)초중、비반인군baPWV、동맥경화발생솔균현저고우정상자,P〈0.001;교정년령、성별、혈압인소후,초중화비반인군동맥경화OR치분별위1.58화2.1;BMI예측동맥경화적최가절점위24.25,차시령민도위67.2%,특이도위57.2%。결론:1)baPWV수착년령증가이증고,차남성고우녀성;2)혈압지표예측PWV평개적동맥경화유교고개치,단고혈압표준구분인군장루진흔대부분혈압정상、동맥강경도각이상자,단순사용혈압지표불능이상지괄용우보통인군혈관병변적조기풍험평고。초중、비반인군baPWV화동맥경화풍험현저고우정상자,BMI예측동맥경화최가절점위24.25,진일보험증료이24작위BMI초중절점괄응성교호;3)PWV화혈압등지표일기인입종합체질측평체계유리우대보통인군진행심혈관질병조기풍험평고급간예,제고체질측평여건강관련성。
Objective:To explore the value of pulse wave velocity(PWV) in integrated physical fitness evaluation.Methods:4522 common residents in Nanjing city were surveyed,and all objects were tested in terms of common indexes of physical fitness and arterial stiffness evaluated by brachial-ankle PWV(baPWV).The study included correlation analysis of the association between baPWV and blood pressure,BMI using receiver operator characteristic(ROC) curve and Kappa test of the positive rate for hypertension and arteriosclerosis and calculation of the optimal cut-off points of BMI for predicting atheroscleross.Results:1) BaPWV increases with the age increasing;Mean baPWV of Nanjing residents is 1383±237cm/s for men and in 1278±246cm/s for women.2) Systolic blood pressure,diastolic blood pressure,pulse pressure were positively correlated with baPWV and has good predictive value(P0.001);Kappa test of positive rate for hypertension and arteriosclerosis showed low consistency and the sensitivity of hypertension to predict atherosclerosis was 36%.3) Compared with normal group,overweight and obesity residents has significant difference in baPWV and prevalence of arteriosclerosis(P0.001);the odds ratio values of overweight and obese population for predicting hypertension are 1.58 and 2.1 with adjusted age.The optimal cut-off point of BMI for evaluating atherosclerosis is 24.25.Conclusions:1) BaPWV increases with the age increasing and shows lower level in women.2) Blood pressure shows a good value to predict atherosclerosis,however,the consistency for positive rate of hypertension and arteriosclerosis is low.It indicates that the diagnostic criteria of hypertension are not suitable for assessing the risk of early atherosclerosis.BaPWV in overweight and obese population is higher than the normal group.3) The integrated evaluation System including baPWV and blood pressure will be of benefits to risk assessment and early intervention for cardiovascular diseases.