持续性非卧床腹膜透析患者增强指数的变化及影响因素

Augmentation index＇s change and its influencing factor in patients on continuous ambulatory peritoneal dialysis

目的应用增强指数（AI）检测持续性非卧床腹膜透析（CAPD）患者的动脉弹性，分析影响AI的因素，评估CAPD患者的动脉弹性功能状况。方法测量46例CAPD患者（CAPD组）及42例健康者（对照组）的身高、体重、血压，检测血液指标，应用桡动脉压力波形分析仪测定AI，分析影响AI的因素。结果CAPD组患者的收缩压、舒张压、脉压、中心动脉压和心率换算成75次／min的AI值（AI。）明显高于对照组。CAPD患者女性的Ah明显高于男性[（96．67±8．95）％比（89．89±6．46）％，P=0．022]。简单相关分析显示，CAPD患者的AI与性别、年龄、收缩压、舒张压、脉压、中心动脉压呈正相关，与身高、体重、体重指数呈负相关，与各项血液指标及透析龄无相关性。多元线性回归分析显示，CAPD患者的AI与性别、年龄、身高、舒张压及中心动脉压存在线性回归关系。结论CAPD患者动脉弹性降低，动脉硬度增加，其AI与年龄、身高、舒张压及中心动脉压密切相关，是部分反映动脉弹性的一个无创指标。中心动脉压与动脉弹性、僵硬度密切相关，临床测定中心动脉压对于预防心血管事件具有重要意义。

Objective To analyze the factors influencing augmentation index （AI） by examining the AI changes in patients who received continuous ambulatory peritoneal dialysis （CAPD） therapy, and evaluate the artery elastic function situation. Methods The height, weight, blood pressure, blood indicators were detected in 46 CAPD patients （CAPD group） and 42 controls （control group）. AI was managed by OMRON HEM-900OAI, and the influencing factor was analyzed. Results Systolic blood pressure（SBP）, diastolic blood pressure（DBP）, pulse pressLlre, central aortic pressure and AIP75 （AI value, when pulse was 75 heats/rain） in CAPD group were significantly higher than those in control group. Within CAPD patients, the AIP75 in female was significantly higher than that in male [ （96.67 ± 8.95）% vs （89.89 ± 6.46）% ,P = 0.022]. Simple correlation showed positive relationship in gender, age, SBP, DBP, pulse pressure and central aortic pressure with AI; and negative relationship in height, weight and weight index with AI; while there was no relationship between AI and all kinds of chemical examination indicators or dialysis years. Multiple linear regression analysis evidenced that gender,age, height, DBP and central aortic pressure of CAPD patients had linear regression relation with AI. Conclusions It indicates a decreased artery elasticity and an increased stiffness occurs in CAPD patients. AI has tight correlation with age, height, DBP and central aortic pressure, and is an non-invasive factor that partially reflects the arterial elasticity. Central aortic pressure is relevant with aortic elasticity and rigidity closely. Measuring central aortic pressure is very importantfor preventing cardiovascular accident.