心-踝血管指数评价高血压患者动脉僵硬度研究

Cardio -ankle vascular index in evaluation of arterial stiffness of hypertensive patients

目的：探讨心-踝血管指数（Cardio-ankle vascular index，CAVI）在高血压病患者动脉僵硬度评价中的应用价值。方法：本研究入选119例原发性高血压患者和106例受检者作为正常对照组。原发性高血压患者119例，其中男性36名，女性83名，平均年龄（55.71±684）岁（范围35-76岁）；正常对照组106例，其中男性32名，女性74例，平均年龄（55.32±9.24）岁（范围40-76岁）。应用血压脉搏测量装置测定上述人群的左侧CAVI（L-CAVI）和右侧CAVI（R-CAVI），作为评价动脉僵硬度的指标。结果：原发性高血压病患者与正常对照组比较，年龄、性别和血脂水平无显著性差异（均为P〉0.05），而收缩压（Systolic blood pressure，SBP）、舒张压（Diastolic blood pressure，DBP）、平均动脉压（Mean blood pressure，MBP）和脉压（Pulse pressure，PP）在高血压组明显升高（均为P〈0.001）。高血压组双侧CAVI显著高于正常对照组（R-CAVI：8.13±1.13比7.48±092，P〈0.001；L-CAVI：8.07±1.09比7.51±0.91，P〈0.001）。相关分析表明高血压组中双侧CAVI仅与PP相关（左侧R=0.316，P〈0.05，右侧R=0.245，P〈0.05）。多因素分析结果显示，无论高血压组还是正常对照组，年龄是影响CAVI的主要因素。结论：高血压患者动脉僵硬度明显增大，CAVI为评价动脉僵硬度改变的有效指标。

Objective ： To explore the value of Cardio - ankle vascular index （CAVI） in evaluation of arterial stiffness of hyper- tensive patients. Methods： 119 essential hypertensive patients and 106 normal subjects were recruited in our study. There were 36 male patients and 83 female patients in hypertensive group, the mean age was 55.71±6.84 years （range 35 -76 years）. There were 32 male subjects and 74 female subjects in normal subjects group, the mean age was 55.32 ±9.24 years （ range 40 - 76 years）. CAVI was measured using validated automatic devices and used as indexes of arterial stiffness. Results ： Age, sex, and blood lipid level had no significant difference in the two groups. SBP, DBP, MBP and PP in patients with essential hypertension were significantly higher than that in normal subjects. Left and right CAVI in essential hypertension group was significantly higher than that in normal subjects （ R - CAVI：8.13±1.13 vs. 7.48±0.92 ,P 〈0.001 ;L - CAVI： 8.07±1.09 vs. 7.51±0.91 ,P 〈0.001）. Simple relationship analysis demonstrated that in hypertensive group -CAVI and R- CAVI were significantly related to PP（ Rleft = 0.316, P 〈0.05 ,Rright = 0.245, P 〈 0.05 ）. Multiple factors analysis revealed that age was the main factor to affect CAVI whether in hypertensive patients or in normal subjects. Conclusions ： Arterial stiffness in patients with essential hypertension was significantly higher than that of normal subjects. CAVI was a useful index for evaluation of arterial stiffness.