臂踝动脉脉搏波传导速度与慢性肾脏病的关系

Association between brachial ankle pulse wave velocity and chronic kidney disease

目的臂踝动脉脉搏波传导速度(baPWV)是心血管病危险及预后的独立预测因子之一,慢性肾脏病(CKD)患者心脑血管事件增加可能与其动脉硬化有关,目前为止有关baPWV与CKD的研究结果尚不一致,本研究主要探讨baPWV与CKD的关系。方法对完成baPWV检测的观察对象19 376人进行分析,平均年龄为50.5岁,其中男性12 533人(64.8%)。CKD包括估算的肾小球滤过率(eGFR)<60 mL/(min·1.73 m^2)或尿蛋白阳性。结果 CKD的发生率随baPWV(三分位)的升高而升高。在Logistic回归分析中,校正了年龄、性别等混杂因素后,以baPWV第1三分位组为对照组,第3三分位组发生eGFR<60mL/(min·1.73m^2)、尿蛋白阳性或CKD的OR值(95%CI)分别为1.34(1.05~1.70)、1.67(1.27~2.16)、1.46(1.21~1.77);以baPWV每增加一个标准差为自变量,校正了多种混杂因素后,发生eGFR<60mL/(min·1.73m^2)、尿蛋白阳性、CKD的OR值(95%CI)分别为1.15(1.05~1.25)、1.24(1.14~1.35)、1.20(1.13~1.29)。结论 baPWV增加与CKD的发生独立相关。

Objective Brachial-ankle pulse wave velocity （baPWV） was one of the independent predictors of cardio- vascular disease risk and prognosis in patients with chronic kidney disease. Cardiovascular and cerebrovascular events increase may be related to atherosclerosis. So far the researches on the relationships between baPWV and chronic kidney disease were not consistent. We mainly disucssed the relationship between baPWV and chronic kid- ney disease. Methods A total of 19 376 individuals received baPWV detection, with mean age of 50.5 years, men 12 533 {64.8-- ）. Chronic kidney disease was defined as the estimated glomerular filtration rate （eGFR）-60 mL/ （mln - 1.73 m^2 ）, or the presence of albuminuria. Results The incidence of chronic kidney disease increased with baPWV tertiles. Logistic regression analysis showed that, compared with tertile 1, OR （95- CI） of eGFR -60 mL/{min - 1.73 m^2 ）, albuminuria or chronic kidney disease in tertiles 3 group were 1.34（1.05-1.70）, 1.67 （1.27-2.16） and 1.46（1.21-1.77） , respectively. After adjusted for various factors, we found that every stand- ard deviation the baPWV increased, the OR [95% CI） of eGFR 〈60 mL/（min·1.73 m^2 ）, albuminuria and chronic kidney disease were 1.15（1.05-1.25）, 1.24（1.14-1.35）and 1.20（1.13-1.29）, respectively. Conclusion The increase of baPWV was independently associated with the occurrence of chronic kidney disease.