中心动脉血压分数与动脉粥样硬化性肾动脉狭窄相关性研究

Relation of fractional diastolic and systolic pressure in the ascending aorta are related to the renal artery stenosis

目的 分析国人动脉中心收缩压分数（FSP）和舒张压分数（FDP）与动脉粥样硬化性肾动脉狭窄的相关性。方法 应用Lead2000多导生理记录仪描记入选研究对象中心压力曲线，并计算中心FSP和FDP以肾动脉造影结果作为分组依据，分为肾动脉狭窄组71例和非肾动脉狭窄组489例，分析中心动脉血压分数FSP、FDP与肾动脉狭窄的关系。结果 肾动脉狭窄组的中心FSP显著高于非肾动脉狭窄组[分别为1．50±0．14 vs 1.39±0．11]，而中心FDP显著低于非肾动脉狭窄组[分别为0．75±0．071 vs 0．80±0．058]，（均P〈0．01）。Logistic回归分析结果示：中心的而非外周的FSP和FDP为影响肾动脉狭窄的独立危险因素（OR=1.092，95％CI=1．03～1．28 for FSP；OR=0．87，95％CI=0．37～0．94 for FDP）。结论 中心动脉FSP。

Objective To explore the relation of ascending aortic fractional systolic pressure（FSP）, fractional diastolic pressure（FDP） to renal artery stenosis（RAS） in Chinese. Methods Patients were divided into the RAS group 71 cases and non-RAS group 489 cases depending on the result of renal artery angiography. Brachial blood pressure （BP） measured using a standard sphygmomanometer was performed in standardized condition. A hard copy of the pressure tracing was made using a LEAD 2000 physiology recorder. FSP was defined as the ratio of systolic blood pressure/mean BP, and FDP was defined as the ratio of diastolic blood pressure/mean BP. A stepwise logistic regression analysis was performed to evaluate the independent effects of hemodynamic variables on the risk of renal artery stenosis. Results FSP in RAS group was significantly higher than that in non-RAS group [1.50 ± 0.14 vs 1.39±0.11（ P 〈0. 0001）];while FDP in the former group was significantly lower[0.75±0.07 vs 0.80±0. 058（ P 〈 0.01） ]. The stepwise logistic regression analysis showed that The FSP, FDP from central aorta instead of brachial BP were independent risk factors for presence of renal artery stenosis （OR= 1. 092, 95%CI= 1.03-1.28 for FSP; OR 0.87, 95%CI=0. 37-0.94 for FDP）. Conclusion FSP, FDP from the ascending aorta, but not those from brachial blood pressure are independent risk factors for predicting presence of renal artery stenosis.