老年人群立位肱-踝脉搏波传导速度和踝臂指数的影响因素分析

Influencing factors of orthostatism brachial-ankle pulse wave velocity and ankle brachial index in the elderly

目的 探讨老年人群立位肱-踝脉搏波传导速度（baPWV）和踝臂指数（ABI）的分布特点及影响因素.方法 采用整群随机抽样方法选择在开滦总医院、开滦总医院林西医院、开滦总医院赵各庄医院参加2010至2011年健康体检且年龄≥60岁的开滦集团离退休员工,进行立、卧位baPWV和ABI检测.采用多因素线性回归分析影响立、卧位baPWV及ABI的因素.结果 （1）入选离退休员工2 464名组成研究队列,将完成立、卧位baPWV和ABI检测的1 601名员工纳入统计分析.研究对象的年龄为（67.5±6.1）岁,男性1 065名（66.5％）.立位和卧位的baPWV分别为（3 885±1 504） crn/s和（1 761±371） cm/s;立位和卧位的ABI分别为1.54±0.21和1.10±0.12.＜65、65～69、70～ 74、≥75岁研究对象的立位baPWV随着年龄增加呈上升趋势,而立位ABI随着年龄增加呈下降趋势（趋势检验,P均＜0.01）.（2）多因素线性回归分析显示,影响立位baPWV的因素包括年龄（β=0.19,P＜0.01）、下肢立位收缩压（β=0.18,P＜0.01）、下肢卧位收缩压（β=0.14,P＜0.01）、立位心率（β=0.30,P＜0.01）、卧位心率（β=0.23,P＜0.01）和体重指数（β=-0.18,P＜0.01）;影响立位ABI的因素包括女性（β=-0.055,P＜0.05）、上肢立位收缩压（β=-0.834,P＜0.01）、下肢立位收缩压（β=0.708,P＜0.01）、下肢卧位收缩压（β=0.099,P＜0.01）和空腹血糖（β=-0.085,P＜0.01）.结论 老年人的立位baPWV和ABI均值均高于卧位.立位baPWV的影响因素包括年龄、下肢立卧位收缩压、立卧位心率和体重指数;立位ABI的影响因素包括女性、上肢立位收缩压、下肢立卧位收缩压和空腹血糖.临床试验注册号中国临床试验注册中心,注册号为ChiCTRTNC-11 001489.

Objective To investigate the distribution and influencing factors of orthostatism brachial-ankle pulse wave velocity（baPWV） and ankle brachial index（ABI） in the elderly.Methods Participants were selected with random sampling from ≥60 years old retired workers,who underwent 2010 to 2011 health check-up in the Tangshan Kailuan Hospital,Kailuan Linxi Hospital,Kailuan Zhaogezhuang Hospital.Multivariate linear regression analysis was used to analyze the influencing factors of orthostatism and supine baPWV and ABI in the elderly.Results （1） A total of 2 464 participants were included,and 1 601 participants （1 065 males （66.5%） and （67.5 ± 6.1） years old） with integral data were analyzed.Orthostatism baPWV was （3 885.4± 1 503.5） cm/s and Supine baPWV was （1 761.2 ± 371.4） cm/s.Orthostatism ABI was 1.54 ±0.21 and supine ABI was 1.10 ±0.12.Orthostatism baPWV increased with increasing age,while orthostatism ABI decreased with aging（trend test,both P 〈 0.01） in 〈 65,65-69,70-74,and ≥75 years old participants.（2） Multiple linear regression analysis showed that the age（β =0.19,P 〈0.01）,lower limbs orthostatism systolic blood pressure（β =0.18,P 〈0.01）,lower limbs supine systolic blood pressure （β =0.14,P 〈 0.01）,orthostatism heart rate （β =0.30,P 〈 0.01）,supine heart rate （β =0.23,P 〈 0.01）,body mass index （β =-0.18,P 〈 0.01） were associated with orthostatism baPWV,and female （β =-0.055,P =0.01）,upper limb orthostatism systolic blood pressure （β =-0.834,P 〈 0.01）,lower limbs orthostatism systolic blood pressure （β =0.708,P 〈 0.01）,lower limbs supine systolic blood pressure （β =0.099,P 〈 0.01） and fasting blood glucose（β =-0.085,P 〈 0.01） were associated with orthostatism ABI.Conclusions Orthostatism baPWV and ABI were significantly higher than those of supine＇s.Age,lower limbs orthostatism and supine systolic blood pressure,orthostatism and supine heart rate,body mass index were associated with orthostatism baPWV.Female,upper limb orthostatism systolic blood pressure,lower limbs orthostatism,supine systolic blood pressure and fasting blood glucose were associated with orthostatism ABI in the elderly.Clinical Trail Registry Chinese Clinical Trail Registry,ChiCTRTNC-11001489.