外周血管动脉粥样硬化与心脏舒张功能的相关性分析

Correlation between peripheral arterial atherosclerosis and cardiac diastolic function

目的 探讨外周血管动脉粥样硬化与心脏舒张功能的相关性.方法 选取2012年11月至2013年10月于北京安贞医院就诊的235例老年患者,所有患者均经血管超声检查发现存在外周动脉粥样硬化斑块,根据心脏舒张功能将患者分为轻度舒张功能不全组（114例）和中度舒张功能不全组（131例）.测量并比较2组患者肱踝脉搏传导速度（baPWV）、踝臂指数、心脏舒张功能指标,对baPWV、踝臂指数与心脏舒张功能相关性做Spearman相关分析.结果 2组患者baPWV、踝臂指数比较差异无统计学意义（P＞0.05）;轻度舒张功能不全组心脏舒张功能指标舒张早期二尖瓣血流速度峰值/舒张晚期二尖瓣血流速度峰值（E/A）和E/舒张早期二尖瓣环运动速度（E/E’）均与baPWV和踝臂指数明显相关,E/A与二者的相关系数分别为-0.682、-0.512;E/E’与二者的相关系数分别为0.724、0.553（P ＜0.05）.在中度舒张功能不全组中,E/A和E/E’与baPWV和踝臂指数均无明显相关性（P＞0.05）.在其他影响因素中,年龄及血尿酸水平均分别与E/A和E/E＇相关,E/A与其相关系数分别为-0.452、-0.434;E/E＇与其相关系数分别为0.522、0.487（P＜0.05）.结论 早期心脏出现舒张功能不全时,心脏的舒张功能与外周血管弹性之间存在较好的功能偶联关系;随舒张功能进一步受损,心脏与血管偶联关系失衡,心脏功能受到包括年龄、血尿酸水平等多种因素的影响.

Objective To evaluate the correlation between peripheral arterial atherosclerosis and cardiac diastolic function.Methods Totally 235 elderly patients with peripheral arterial atherosclerotic plaque diagnosed by ultrasound were enrolled and divided into mild dysfunction group （114 cases） and moderated dysfunction group （131 cases） according to the cardiac diastolic dysfunction grade.The brachial-ankle pulse wave-velocity （baPWV）,ankle-brachial index （ABI） and cardiac diastolic function were assessed and compared between the two groups.The Spearman analysis was performed to evaluate the correlation between cardiac diastolic function with baPWV and ABI.Results There were no significant differences in baPWV and ABI between the two groups （P 〉 0.05）.In mild dysfunction group,the indices of cardiac diastolic function such as mitral valve peak early diastolic blood flow velocity/mitral valve late diastolic flow velocity （E/A） and E/mitral annulus velocity （E/E＇） were both correlated with baPWV （r =-0.682,0.724） and ABI （r =-0.512,0.553） （P 〈 0.05）.In moderate dysfunction group,E/A and E/E＇were not correlated with baPWV and ABI （P 〉 0.05）,while were correlated with age （r =-0.452,0.522） and uric acid （r =-0.434,0.487） （P 〈 0.05）.Conclusion The cardiac diastolic function shows a correlation with peripheral vascular elasticity in mild cardiac diastolic dysfunction patients.