云南农村自然人群冠状动脉钙化与脉压差的关系

Relationship Between Coronary Artery Calcification and Pulse Pressure Difference in the Rural Population of Yunnan Province

目的：在了解云南农村自然人群冠状动脉钙化及冠状动脉钙化积分（CACS）的分布情况的基础上，进一步探讨冠状动脉钙化及CACS与脉压差的关系。方法：对云南农村自然人群进行随机分层整群抽样，采用16排螺旋计算机断层摄影术（CT）对212名受试者进行冠状动脉扫描，评估冠状动脉钙化程度，并应用Agatston积分法计算冠状动脉钙化积分，按性别、年龄、钙化积分等分组，比较各组间脉压差，探讨冠状动脉钙化及CACS与脉压差相关性。结果：51～60岁组的平均脉压差为（44．67±13．87）mmHg（1mmHg=0．133kPa），61～71岁年龄组平均脉压差为（50．00±17．44）mmHg，差异有统计学意义（P=0．015），且发现脉压差与年龄呈正相关（rs=0．202，P=0．003）。按CACS分组，CACS≥100组的平均脉压差[（55．22±18．79）mmHg]大于CACS〈I组[（46．87±15．46）mmHg]和1≤CACS〈100组[（45．20±15．89）mmHg]，差异有统计学意义（P〈0．05）。CACS≥100组的脉压差增大的患者比例（47．1％）同样大于CACS〈1组（17．3％）和1≤CACS〈100组（15．2％），差异有统计学意义（P〈0．05）。在冠状动脉钙化阳性受试者中采用Spearman秩相关分析脉压差与CACS的相关性，结果显示脉压差与CACS呈正相关（相关系数rs=0．282），相关性有统计学意义（P=0．047），且在考虑年龄、胆固醇等混杂因素后仍存在正相关关系（回归系数B=0．887）。结论：云南省农村自然人群的冠心病危险因素脉压差与CACS有关，在冠状动脉钙化者中CACS随脉压差的增大而增大。

Objective： Based on coronary artery calcification （CAC） distribution in the rural population of Yunnan province, we further explored the relationship between coronary artery calcification score （CACS） and the pulse pressure difference （PPD）. Methods： A randomly stratified cluster sampling method was used to study the rural population of Yunnan province and 16-MDCT scan was performed in 212 subjects for evaluating their CAC and calculating CACS. The subjects were divided into 2 sets of groups according to the age and CACS value. Age （51-60） years group, n=108 and Age （61-71） years group, n=104; CACS〈l group, n=162, 1 ≤CACS〈100 group, n=33 and CACS〉100 group, n=17. The PPD level and the relationship between CACS and PPD were compared among different groups. Results： The average PPD level in Age （61-71） years group was （44.67±13.87） mmHg and in Age （61-71） years group was （50.00±17.44） mmHg, P=0.015, PPD was positively related to age, rs=0.202, P=0.003. The average PPD level in CACS〉100 group, CACS〈I group and 1≤CACS〈100 group were （55.22±18.79） mmHg, （46.87±15.46） mmHg and （45.20±5.89） mmHg respectively, P〈0.05. The patients with increased PPD level in CACS〉100 group was 47.1%, in CACS〈I group was 17.3% and in I〈CACS〈100 group was 15.2%, P〈0.05. Spearman rank correlation analysis indicated that PPD level was positively related to CACS, rs=0.282, P=0.047, with adjusted confounding factors such as age and blood cholesterol level, the PPD was still positively related to CACS. Conclusion： PPD as a risk factor of coronary artery disease is related to CACS in rural population of Yunnan province, the CACS increased accordingly with the elevated PPD level.