男性代谢综合征患者踝臂指数的群组研究

The relationship between ankle brachial index and all-cause and cardiovascular disease mortality in Chinese metabolic syndrome male cohort

目的研究男性代谢综合征患者踝臂指数(ABI)与全因及心血管疾病病死率的关系。方法收集上海、北京地区男性代谢综合征患者1224例,分为低 ABI 组(ABI≤0.9)与正常 ABI 组(ABI 0.9～1.4),测量其完整的基线资料,并进行随访调查。结果经过(13.2±2.7)个月,共死亡89例,其中40例为心血管疾病死亡。随着 ABI 值的降低,人群全因及心血管疾病病死率有显著升高趋势,Cox 回归分析显示ABI≤0.9与两者显著相关。低 ABI 组的生存率显著低于正常 ABI 组。结论低 ABI 是男性代谢综合征患者发生全因及心血管疾病死亡的独立性危险因素,在该人群中早期运用ABI 测定对心血管疾病死亡具有预测价值。

Objective Ankle brachial index （ABI） is thought to be an efficient means of objectively assessing the potency of lower extremity arterial system. This study is aimed to evaluate the relationship between ABI and cardiovascular disease CVD mortality in Chinese male patients with metabolic syndrome（MS）. Methods 1224 Chinese male patients with MS were selected from Beijing and Shanghai and the baseline examinations were carried out. All the participants were divided into 2 main groups： ABI≤ 0. 9 （ n = 268 ） and ABI 0. 9-1.4 （ n = 956）. and they were followed up for （ 13.2 ± 2. 7） months. Results As to baseline characteristics, age, systolic blood pressure （SBP）, hypertensive disease and diabetes mellitus morbidity and smoking history had significant difference between the 2 groups （ P 〈 0. 05 or P 〈 0. 01 ）. All-canse mortality and CVD mortality decreased gradually while the ABI increased from 0. 4 to 1.4. With Cox regression analysis, relative ratio （RR） value of all-cause mortality and CVD mortality also showed the decreasing trend with the rising of ABI. Conclusion In Chinese male patients with MS, ABI is one of the most important parameters in indicating possible prognosis and foreseeing all-cause and CVD mortality. Male subjects with relatively old age, higher systolic blood pressure, hypertensive disease and diabetes mellitus morbidity, smoking history may be associated with lower ABI （ ≤0. 9） and relatively higher all- cause and CVD mortality. Our results suggest the urgent need for frequent measurement of the ABI in clinical practice before diagnosing peripheral artery disease and making therapeutic decision, especially in some high-risk population such as male patients with MS.