健康体检人群脉搏波传导速度及其相关因素分析

Evaluation of arterial stiffness and related risk factors in healthy examination subjects

目的 健康体检人群脉搏波传导速度(pulse wave velocity,PWV)及其相关因素分析.方法 入选健康体检323人,根据PWV水平分为两组:对照组(PWV＜9 m/s)37人,观察组(PWV≥9m/s) 286人.PWV由Complior仪器测定.结果 观察组人群高血压发病率显著高于对照组.观察组收缩压、舒张压、脉压、甘油三酯水平均显著高于对照组[(141.2±19.9) mmHg比(129.0±18.8)mmHg,P＜0.001; (88.4± 11.1) mmHg比(82.1±10.8) mmHg,P=0.001; (52.8±12.9) mmHg比(46.8±10.6) mmHg,P=0.007;(2.13±1.64) mmol/L比(1.19±0.73) mmol/L,P＜0.001)].观察组高密度脂蛋白胆固醇(HDL-C)水平显著低于对照组[(1.26±0.37) mmol/L比(1.51±0.40)mmol/L,P=0.002)].相关性分析提示总体人群中PWV与年龄、收缩压、舒张压、脉压、血糖、糖化血红蛋白、尿酸、甘油三酯呈显著正相关性(γ=0.124,0.307,0.259,0.255,0.187,0.340,0.169,0.278,均P＜0.05),而与HDL-C呈显著负相关性(γ=-0.283,P＜0.001).多元线性回归分析提示PWV与收缩压、糖化血红蛋白有关(β=0.314,P=0.003;β=0.307,P=0.003).结论 PWV是动脉僵硬度的评价指标,高密度脂蛋白胆固醇可能参与了其中的保护作用,具体机制有待于进一步探讨.

Objective To investigate the possible risk factors involving pulse wave velocity (PWV) in healthy people.Methods 323 subjects from Shougang Corporation examination center were enrolled into our study.They were divided into two groups:PWV＜9 m/s(n=37)group and PWV ≥ 9 m/s(n=286) group.Carotid-femoral pulse wave velocity (CF-PWV) was detected by the Complior apparatus.Results The incidence of hypertension was significantly higher in PWV ≥ 9 m/s group.The levels of systolic blood pressure (SBP),diastolic blood pressure (DBP),pulse pressure (PP),triglycerides (TG) were significantly higher in PWV ≥ 9 m/s group than in control group [(141.2 ± 19.9)mmHg vs (129.0 ± 18.8)mmHg,P＜0.001;(88.4 ± 11.1)mmHg vs (82.1 ± 10.8) mmHg,P=0.001;(52.8 ± 12.9)mmHg vs (46.8 ± 10.6) mmHg,P=0.007;(2.13 ± 1.64)mmol/L vs (1.19 ± 0.73)mmol/L,P＜0.001)].High-density lipoprotein cholesterol (HDL-C) was higher in PWV＜9 m/s group.PWV was positively correlated with age,SBP,DBP,PP,glucose,HbA1c,uric acid,TG in the entire study group(γ =0.124,0.307,0.259,0.255,0.187,0.340,0.169,0.278,respectively,all P＜0.05).There was negative correlation between PWV and HDL-C in the entire group(γ=-0.283,P＜0.001).Multivariate analysis showed that SBP,HbA1c were significant independent associating factors of PWV in all subjects(β =0.314,P=0.003; β =0.307,P=0.003).Conclusion The levels of SBP,DBP,PP,TG were significantly higher in PWV ≥ 9m/s group than that in control group.HDL-C might play an important role in the development of arterial stiffness.More studies should be investigated in future.