心血管病高危人群臂踝脉搏波速度的临床应用

Application of Brachial-Ankle Pulse Wave Velocity in High Cardiovascular Risk Patients

目的观察心血管病高危人群臂踝脉搏波速度(baPWV)与心血管病危险因素和临床心脑血管事件的相关性。方法连续入选111例心血管病高危患者,进行baPWV、身高、体重、腰围、血压、心率测量,病史采集及血液生化检查。高危人群定义为既往发生过心脑血管事件(冠心病、缺血性脑卒中、短暂性脑缺血发作)或具有两种以上心血管危险因素(年龄≥50岁、吸烟、肥胖、高血压病、糖尿病、高脂血症)的人群。比较高baPWV组(≥1700cm/s)与低baPWV组(<1700cm/s)患者具有危险因素个数和临床心脑血管事件发生情况的差异。结果与低baPWV组相比,高baPWV组心脑血管事件发生率较高(分别为35.3%和60.5%,P<0.01),心血管危险因素数目较多[(3.9±1.2)和(4.4±0.9),P<0.05]。影响baPWV的因素主要为年龄(P<0.001)和收缩压(P<0.01)。结论在心血管病高危人群中,baPWV较高的患者心脑血管事件发生率高,心血管危险因素多。年龄和收缩压是影响baPWV的独立危险因素。

Objective To observe the relationship between brachial-ankle pulse wave velocity （baPWV） and cardiovascular risk factors as well as clinical cardiovascular events in high cardiovascular risk patients. Methods Relevant clinical data, including baPWV, height, weight, waist circumference, blood pressure, heart rate, history and blood biochemistry test were collected in 111 consecutive patients with high cardiovascular risk. High cardiovascular risk patients are defined as those who developed cardiovascular events （coronary heart disease, ischemic stroke and transient ischemic attack） before or those who have two or more cardiovascular risk factors （more than 50 years old, smoking, obesity, hypertension, diabetes mellitus and hyperlipidemia）. The number of risk factors and cardiovascular events between patients with high baPWV （9 1700 cm/s） and low baPWV （〈 1700 cm/s） were compared. Results Compared with low baPWV group, the cardiovascular events and the number of cardiovascular risk factors were higher in high baPWV group （35.3% versus 60.5%, P〈0.01 and （3.9±1.2） versus （4.4±0.9）, P〈0.05, respectively）. The factors influencing baPWV were age （P〈0.001） and systolic blood pressure （P〈0.01）. Conclusion In patients with high cardiovascular risk, the cardiovascular events and the number of risk factors were more frequent in patients with higher baPWV. Age and systolic blood pressure are independent risk factors of baPWV.