高血压合并糖尿病肾病病变程度与心踝血管指数的相关性研究

Relationship between cardio-ankle vascular index and condition of patients with hypertension and diabetic,nephropathy

目的分析高血压(HT)合并糖尿病肾病(DN)患者病变程度与心踝血管指数(CAVI)的相关性,及其对预后判断的价值。方法将HT合并2型糖尿病患者104例依据是否罹患DN分为:观察组54例(罹患DN)和对照组50例(未罹患DN)。比较2组的CAVI、尿微量白蛋白(MAU)、血肌酐(SCr)、尿白蛋白/肌酐比值(ACR)、TG、TC、LDL-C以及肾小球滤过率(GFR)、颈动脉内膜一中层厚度(IMT)的差异。随访1年,分析患者发生主要不良心血管事件(MACE)与上述指标的相关性。结果与对照组比较,观察组的CAVI、MAU、SCr、ACR、TC、LDL-C及IMT明显较高,而GFR明显较低(P<0.05),TG无显著差异(P>0.05)。直线相关分析显示,MACE与CAVI、MAU、ACR、LDL-C、IMT呈正相关(r=0.642、r=0.723、r=0.589、r=0.623、r=0.540,P<0.05或P<0.01),与GFR呈负相关(r=-0.696,P=0.021),而多元Logistic回归分析显示MACE仅与CAVI、MAU呈正相关(OR=3.287,95%CI3.302～10.874,P=0.015:OR=3.461,95%CI 4.957～21.380,P=0.004)。结论 CAVI能较好地反映HT合并DN患者的病情程度以及判断患者的预后。

Objective To analyze the relationship between cardio-ankle vascular index（CAVI） and the condition of patients with hypertension（HT） and diabetic nephropathy（DN） and the clinical value of prognosis.Methods A total of 104 patients with HT and type 2 diabetes mellitus were included and divided into two groups,research group（54 cases,accomplished with DN） and control group（50 cases,non-accomplished with DN）,according to the diagnosis of DN.The indexes of CAVI,micro albuminuria（MAU）,serum creatinine（SCr）,urinary albumin to creatinine ratio（ACR）,TG,TC,LDL-C, glomerular filtration rate（GFR） and carotid intima media thickness（IMT） were compared between two groups.The relationships between the occurrence of major adverse cardiac events（MACE） and above indexes were analyzed after one year follow up.Results Compared to control group,the indexes of CAVI,MAU,SCr,ACR,TC,LDL-C and IMT in research group were higher,and GFR was lower（P0.05）,but TG shows no different（P0.05）.The positive correlations between the occurrence of MACE and CAVI,MAU,ACR,LDL-C and IMT were confirmed by linear correlation analysis（r=0.642,r= 0.723,r=0.589,r=0.623,r=0.540,P0.05,P0.01）,there was negative correlation between MACE and GFR （r=0.696,P=0.021）.And the positive correlations between the occurrence of MACE and CAVI,MAU were confirmed by multivariate Logistic regression analysis（OR=3.287,95%CI 3.302～10.874,P=0.015;OR=3.461,95%CI 4.957～21.380,P=0.004）.Conclusion The CAVI could reflect the severity and prognosis of patients with HT and DN.