心-踝血管指数——动脉粥样硬化无创检测指标：845例分析

Cardio-ankle vascular index a marker of atherosclerosis： analysis of 845 cases

目的用无创方法检测青年和老年人心．踝血管指数（CAVI），分析动脉粥样硬化（AS）和血管硬度的影响因素。方法845例住院、门诊及正常体检者（男594例、女251例，年龄35-85岁）测定CAVI，并进行诊室血压、血脂、血糖、肾功能、心电图及胸部X线检查，记录既往史。结果845例中54．2％CAVI异常（458例）；CAVI增加与年龄、血压、脉压差等因素密切相关；随年龄增长，并存疾病如高血压、糖尿病、冠心病、脑卒中及血脂异常，特别是冠心病、高血脂检出率升高；吸烟对CAVI影响显著，吸烟并存疾病可使CAVI进一步升高。结论CAVI是新的AS评估指标，与多种因素有关，吸烟及吸烟并存疾病对CAVI均有明显影响。结果提示，AS应根据患者各自不同的影响因素进行个性化综合防治。

Objective To determine the risk factors of atherosclerosis（AS） and arterial stiffness assessed non-invasively by the cardio-ankle vascular index（CAVI）. Methods A total of 845 subjects aged from 35 to 85 years were subjected to CAVI measurement. Blood pressure（BP）, lipids, glucose, renal function, chest X-ray radiographs, previous medical records were also obtained for all subjects. CAVI was measured using a VaSera VS-1000 and calculated by heart to ankle pulse wave velocity（haPWV, m/s）. Results CAVI was high in 458 subjects（54.2%）. CAVI was significantly positively correlated with age, BP, and pulse pressure. Detection rates of hypertension, diabetes, coronary artery disease（CHD）, stroke and dyslipidemias, especially CHD and hyperlipidemias, increased with aging. Smoking was significantly correlated with CAVI. The smokers with other comorbidities displayed further higher CAVI. Conclusions CAVI, as a new parameter of arterial stiffness, is influenced by various cardiovascular risk factors. Smoking and the comorbidities are all involved in elevation of CAVI. A personalized comprehensive prevention and treatment strategy should be recommended for patients with AS.