老年住院患者周围血管病变筛查及其与代谢指标的相关性研究

Correlation research of the prevalence of peripheral arterial disease and metabolism index in the hospitalized gerontal patients

目的探讨老年住院患者周围血管病变(PAD)的患病率,并分析其与代谢异常的关系。方法纳入60岁以上住院患者213例,通过电子血压计检测踝肱指数(ABI)进行分组:PAD组和非PAD对照组。所有患者检测空腹血糖(FBG)、血脂、C-反应蛋白(CRP)、尿酸(SUA)、同型半胱氨酸(HCY)、尿白蛋白排泄率(UAER)、空腹胰岛素(FIns)等,通过多元逐步回归分析探讨影响PAD的危险因素。结果 213例住院患者中PAD组35例(16.43%);非PAD对照组178例(83.54%)。PAD组年龄、舒张压与非PAD对照组比较差异无统计学意义(t值为0.47、1.53,P>0.05);腰围、收缩压(SBP)、FBG、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白(α)[Lp(α)]、载脂蛋白B100(APOB)、HCY、CRP、肌酐(Cr)、SUA、UAER、FIns、胰岛素抵抗指数(HOMA-IR)明显增高(t值分别为4.25、10.08、4.684、.334、.684、.144、.51、2.47、2.206、.29、4.01、3.48、12.09、8.85、15.63,P<0.01或P<0.05);高密度脂蛋白胆固醇(HDL-C)或脂蛋白A1(APOA1)明显低于非PAD对照组(t值为6.12、5.93,P<0.01)。多元逐步回归分析显示,HOMA-IR、UAER、SBP、Lp(a)是影响PAD的独立危险因素。结论 16.43%的老年住院患者存在PAD,电子血压计测量ABI简单、准确,可用于临床进行PAD患者的筛查。HOMA-IR、UAER、SBP、Lp(a)是加剧PAD的主要因素。

Objective To investigate the morbidity rate of peripheral arterial disease（PAD） of the hospitalized gerontal patients and analyze the relationship between PAD and metabolic disorder.Methods Two hundred and thirteen hospitalized gerontal patients above 60 years old were enrolled in this study.ABI（ankle-brachial pressure index） assessments were performed using electronic sphygmomanometer and all patients were divided into group A（with PAD） and group B（without PAD）.Fasting blood glucoses,pectrum of blood fat,C-reactive protein（CRP）,uric acid（SUA）,homocysteine（HCY）,albumin excretion ratio（UAER）,fasting insulin level（FIns） were measured in all the subjects.Multi-factorial logistic stepwise regressison analysis was used to screen the risk factors relevant to PAD.Results Among the 213 hospitalized gerontal patients,there were 35 cases（16.43%）in group A,and 178 cases（83.54%）in group B.Difference of age and diastolic blood pressure between the two groups were not statistical significance（t=0.47,1.53,P0.05）,waist circumference,systolic pressure（SBP）,SBG,TC,TG,LDL-C,Lp（a）,APO-B100,HCY,CRP,Cr,SUA,UAER,FIns,HOMA-IR were obviously higher in group A than those in group B（t=4.25,10.08,4.68,4.33,4.68,4.14,4.51,2.47,2.20,6.29,4.01,3.48,12.09,8.85,15.63,P0.01or P0.05）,HDL-C and APOA1 in group A were obviously lower than those in group B（t=6.12,5.93,P0.01）.HOMA-IR,UAER,SBP,Lp（a）were the independent risk factors relevant to PAD by logistic stepwise regression.Conclusion About 16.43% hospitalized gerontal patients above 60 years old accompany with PAD.The method of ABI（ankle-brachial pressure index） performed using electric sphygmomanometer was simple and accurate,and can be applied in screening patients with PAD.HOMA-IR,UAER,SBP,Lp（a） are the independent risk factors relevant to PAD.