代谢综合征患者肱踝动脉脉搏波传导速度观察

Brachial ankle pulse wave velocity in the patients of metabolic syndrome

目的观察代谢综合征（MS）患者肱踝动脉脉搏波传导速度（baPWV），探讨MS患者早期动脉硬化功能的改变情况。方法对5476名年龄25～75岁的体检人群测定血压、腰围、空腹血糖、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等组分；采用VP-1000（BP-203RPEⅢ）动脉硬化诊断仪测定baPWV；分析代谢综合征及各组分与baPWV的关系。结果5476名体检者中，MS患者1684例，非MS者3792名。（1）MS组baPWV及baPWV异常改变率均高于非MS组，差异均有统计学意义[1419．0（1284．0～1586．5）cm／s比1275．0（1160．5～1419．6）cm／s，16．3％（6．6％～27．3％）比7．1％（1．0％～17．2％），均P〈0．01]；随异常代谢组分数目的增加，baPWV值、baPWV改变率随之增加。（2）baPWV与收缩压、舒张压、空腹血糖、腰围、甘油三酯、总胆固醇、低密度脂蛋白胆固醇等均呈正相关，rs分别为0．62、0．45、0．22、0．21、0．16、0．15、0．09（均P〈0．01）。（3）多元回归分析显示对baPWV影响最重要的组分为收缩压、空腹血糖、低密度脂蛋白胆固醇和甘油三酯。结论MS有早期动脉管壁弹性功能改变，baPWV检测有助于评估MS患者早期心血管病变。

Objective To investigate the association between metabolic syndrome （MS） and brachial ankle pulse wave velocity （baPWV）. Methods A total of 5476 subjects were enrolled from annual health checkups. Blood pressure, fasting plasma glucose, waist circumference, triglyceride, cholesterol, high-density and low-density lipoprotein cholesterols were measured routinely. And baPWV was determined by VP-1000 （ BP-203RPE Ⅲ ）. Results The values of baPWV and its change rates in MS patients were both higher than those in non-MS subjects respectively （ 1419. 0 （ 1284. 0 - 1586. 5 ） cm/s vs 1275.0 （1160.5-1419.6） cm/s, 16.3% （6.6%-27.3%） vs 7.1% （1,0%-17.2%）, both P〈0.01）. Systolic blood pressure, fasting blood glucose, low-density lipoprotein cholesterol and triglyceride were the important influencing components of baPWV. Conclusion MS patients have early alterations of arterial wall elasticity and function. And examination of oulse wave velocity helps to screen early arteriosclerosis.