肱踝脉搏波速度测定在心血管病风险评估中的应用

Application of brachial ankle pulse wave velocity in cardiovascular risk assessment

目的探讨肱踝脉搏波速度(baPWV)与心血管病危险因素的相关性,以及在心血管病风险评估中的价值。方法入选309例具有心血管病危险因素的患者,测量baPWV、身高、体质量、腰围、血压,检测血脂、血糖、尿酸、肌酐、血同型半胱氨酸等,收集临床资料,并进行Framingham风险评分(FRS)。比较高baPWV组(≥1 750 cm/s)与低baPWV组(<1 750 cm/s)心血管病危险因素的差异。分析baPWV与心血管危险因素积累和FRS之间的关系。结果两组在年龄、三酰甘油、血糖、尿酸、收缩压、舒张压、脉压、高血压史、糖尿病史、心血管病家族史有统计学差异(均P<0.05),多因素Logistic回归分析显示主要影响因素为年龄(P<0.01)、收缩压(P=0.01)、高血压病(P<0.01)和心血管病家族史(P<0.05)。而且,随着心血管危险因素个数的积累,baPWV水平呈逐渐上升趋势(P<0.01)。随着FRS风险等级的增加,baPWV水平呈上升趋势(P<0.01)。结论 baPWV升高可能预示着心血管病危险因素累积个数增加和(或)心血管病风险升高。年龄、收缩压、高血压病史和心血管病家族史是影响baPWV的主要危险因素。

AIM To investigate the correlation between brachial-ankle pulse wave velocity ( baPWV ) and cardiovascular risk factors and its value in cardiovascular risk assessment. METHODS 309 patients with risk factors of cardiovascular disease were enrolled in the investigation. All the patients had physical examination and laboratory studies. Their clinical data were collected and Framingham risk scores ( FRS) were measured. The differences of cardiovascular risk factors between the high baPWV group (> 1750 cm/s) and the low baPWV group (< 1 750 cm/s) were compared and the correlation between baPWV and cardiovascular risk factors and FRS was analyzed. RESULTS The two groups were statistically different in age, triglyceride, blood sugar, uric acid, systolic pressure, diastolic pressure, pulse pressure, hypertension history, diabetes mellitus history, and family history of cardiovascular disease ( P < 0. 05 ). Multivariate logistic regression analysis showed that the main risk factors for baPWV were age ( P <0. 01), systolic blood pressure (P =0.010), hypertension history (P <0. 01 ) and family history of cardiovascular disease (P =0.045). Moreover, with the accumulation of cardiovascular risk factors, the level of baPWV increased gradually (P < 0. 01). With the increase of FRS level, baPWV level demonstrated an upward trend (P < 0. 01 ). CONCLUSION The increase of baPWV may indicate a cumulative increase in cardiovascular risk factors and/or a higher risk of cardiovascular disease. Age, systolic blood pressure, histoiy of hypertension, and family history of cardiovascular disease are the major risk factors for baPWV.