BaPWV改变在冠心病及其早期临床病变的应用研究

BaPWV Changes in Coronary Heart Disease and Early Clinical Pathological Changes of Applied Research

目的:通过对冠心病及早期临床病变患者进行综合干预,观察踝臂脉搏波速度(baPWV)在此过程中的变化,探讨baPWV的改变在冠心病及其早期临床病变的应用研究。方法:选择冠心病患者178例,冠心病早期临床病变患者189例,收集患者一般临床资料,监测血压、血糖、血脂及双侧baPWV等指标,从生活方式、药物治疗及严格随访等方面综合干预,随访18个月后复测上述指标进行分析比较,观察心脑血管疾病的发生情况。结果:冠心病早期临床病变患者在研究过程中失访或退出42例,18个月后剩余147例,其中84例按计划完成干预及随访(完成组),63例未能按计划完成(未完成组)。完成组BMI、DBP、SBP、TG、LDL-C、baPWV水平均明显降低,差异有统计学意义(P<0.05),空腹血糖(FPG),总胆固醇(TC),高密度脂蛋白(HDL-C)水平较前差异无统计学意义(P>0.05)。未完成组仅在SBP、LDL-C水平均明显降低,差异有统计学意义(P<0.05)。完成组新发心脑血管疾病发生率低于未完成组,差异有统计学意义(P<0.05)。冠心病患者在研究过程中失访或退出39例,18个月后剩余139例,其中87例按计划完成干预及随访(完成组),52例未能按计划完成(未完成组)。完成组在BMI、SBP、DBP、HbA1、FPG、TC、TG、LDL-C、baPWV较前均明显减轻,差异有统计学意义(P<0.05);未完成组在SBP、DBP、TG、LDL-C、baPWV等指标前后比较,差异有统计学意义(P<0.05)。完成组心绞痛发生率及新发心脑血管疾病发生率低于未完成组,差异有统计学意义(P<0.05)。结论:通过综合干预冠心病及其早期临床病变,可有效控制危险因素,降低患者baPWV等水平,缓解症状,减少心、脑血管疾病发生。在此过程中可以把baPWV变化作为监测冠心病及其早期临床病变和病情变化的综合指标之一。

Objective Through comprehensive interventing to the coronary heart disease（ CHD）and early clinical disease of patients, we observed brachial-ankle pulse wave velocity（ baPWV）in the process of change and discuss the changes of baPWV in coronary heart disease and early clinical pathological changes of applied research. Method Choosing 178 cases diagnosed patients with CHD,CHD pa-tients with early clinical lesions in 189 cases. All patients were collected some clinical data,measuring blood pressure,blood sugar,＆amp;nbsp;blood fat monitoring and double side baPWV etc,intervenes comprehensively from the way of life,drug treatment and strictly follow-up and follow-up of 18 months. Later all in the indicator patients repetition carries on the comparison and analysis,observed the heart and cerebro-vascular disease conditions. Results CHD in patients with early clinical pathological changes lost to follow-up or exit in the study of 42 ca-ses,after 18 months the remaining 147 cases,the remaining 84 cases as planned to complete the intervention group（ completed group）and follow-up,63 failed to complete as planned（ incompleted group）. Completed group of body mass index（ BMI）,systolic blood pressure （ SBP）,diastolic blood pressure（ DBP）,triglyceride（ TG）,low density lipoprotein（ LDL-C）,baPWV level were significantly lower than before intervention（P﹤0. 05）;fasting plasma glucose（FPG）,total cholesterol（TC）,high density lipoprotein（HDL-C）level were no change than the previous（P﹥0. 05）. Incompleted group in SBP,FPG,baPWV level were better than before（P﹤0. 05）. The heart cerebro-vascular disease incidence in Completed group were lower than that in Incompleted group（P﹤0. 05）. CHD in patients pathological changes lost to follow-up or exit in the study of 39 cases,after 18 months the remaining 139 cases,the remaining 87 cases as planned to complete the intervention group（ completed group）and follow-up,52 failed to complete as planned（ incompleted group）. Completed group of BMI, SBP,DBP,HbA1,FPG,TC,TG,LDL-C,baPWV level were significantly lower than before intervention（P﹤0. 05）. Incompleted group in SBP、DBP、TG、LDL-C,baPWV level were better than before（ P﹤0. 05）. The heart cerebrovascular disease incidence in Completed group were lower than that in Incompleted group（ P﹤0. 05 ）. Conclusion Through the comprehensive intervention coronary heart disease and early clinical pathological changes,it can effectively control risk factors,reduce patient baPWV and level,alleviate the symptoms and reduce heart cerebrovascular disease. In this process,it can take baPWV change as one of the comprehensive index monitoring coronary heart dis-ease and early clinical disease illness changes.