踝臂脉搏波速度及糖化血红蛋白与冠心病危险因素的关系

Relationship between brachial-ankle pulse wave velocity,HbA_(1c) and risk factors for coronary heart disease

目的探讨踝臂脉搏波速度(baPWV)、糖化血红蛋白(HbA1c)与冠心病(CHD)危险因素的关系。方法选择CHD患者87例,其中无糖尿病46例(A组),合并糖尿病41例(B组),另选健康体检者80例作为对照组。收集3组的年龄、腰围、收缩压(SBP)、舒张压(DBP)、脉压差(PP)、血脂、空腹血糖(FPG)及HbA1c检测指标,并检测其baPWV,分析CHD的相关危险因素。结果 3组间年龄、腰围、血压、PP、HbA1c、LDL-C、baPWV比较,P<0.01或<0.05;A、B组腰围、FPG、HbA1c、TG、TC、LDL-C、baPWV比较,P<0.01或<0.05。Logistic回归分析显示,高龄、baPWV、DBP、PP、TC、LDL-C、HbA1c是CHD的危险因素,其危险程度从高到低依次为高龄、baPWV、DBP、PP、HbA1c、LDL-C、FPG(P<0.01或<0.05)。A组baPWV与年龄、SBP、DBP、PP、TC、LDL-C、HbA1c呈正相关,B组baPWV与年龄、SBP、DBP、PP、TC、LDL-C、HbA1c、FPG呈正相关,C组baPWV与年龄、SBP、PP呈正相关,P<0.01或<0.05。结论 baPWV与CHD的主要危险因素HbA1c有相关性,baPWV、HbA1c对CHD发病有预测价值。

Objective To explore the relationship between brachial-ankle pulse wave velocity （baPWV）, HbAlc and risk factors for coronary heart disease （CHD）. Methods Eighty-seven patients with CHD including 46 patients without diabetes mellitus （group A） and 41 patients with diabetes mellitus （group B） were selected as well as 80 healthy controls （ group C）. Every patientg information including age, waistline, systolic blood pressure （SBP）, diastolic blood pressure （ DBP）, pulse pressure （ PP）, blood lipid, fasting plasma glucose （FPG） and hemoglobin Alc （ HhAlc ） was recorded ; baPWV of everyone was measured and related risk factors for CHD were analyzed. Results The differences in age, waist- line, blood pressure （BP）, PP, HbAlc, LDL-C and baPWV were statistically significant among 3 groups （P 〈0.01 or 〈 0.05 ）. The differences in waistline, FPG, HbAlo, TG, TC, LDL-C and baPWV between group A and B were statistically significant（P 〈0. O1 or 〈 O. 05）. Logistic regression analysis showed that age, baPWV, DBP, PP, TC, LDL-C and HbAlc were risk factors for CHD. According to OR value size, danger levels from high to low were as follows： age, baP- WV, DBP, PP, HbAlc, LDL-C and FPG （P 〈 0.01 or 〈 0.05 ）. The baPWV of group A was positively correlated with age, SBP, DBP, PP, TC, LDL-C and HbAlc; the baPWV of group B was positively correlated with age, SBP, DBP, PP, TC, LDL-C, HbAlc and FPG; and the baPWV of group C was positively correlated with age, SBP and PP （P 〈0.01 or P 〈 0.05 ）. Conclusion The baPWV is associated with the main risk factor HbAlc of CHD. The baPWV and HbAlc have predictive value for the onset of CHD.