不同性别患者肱动脉脉压升高与冠心病患病风险的关系

Correlation between elevation of brachial artery pulse pressure increased and coronary heart disease in different genders

目的探讨不同性别患者肱动脉脉压升高与冠心病患病风险的关系。方法连续入选2011年12月至2017年6月疑似稳定型冠心病住院患者5116例,依据冠脉CT血管造影分2组:冠心病组(n=3694)和非冠心病组(n=1422)。收集所有研究对象临床资料,分别建立不同性别冠心病患病的Logistic回归模型。结果高血压病、血脂异常、2型糖尿病、缺血性脑卒中和脉压升高的患病率,冠心病组较非冠心病组高(均P<0.05)。男性、女性组的脉压曲线下面积(AUC)分别为0.540、0.612,最佳诊断界值分别为50、60 mmHg(1 mmHg=0.133 kPa)。Logistic回归发现:除经典危险因素,高血压病、2型糖尿病、低密度脂蛋白升高、缺血性脑卒中、吸烟外,脉压升高也是冠心病的危险因素。男性组:脉压升高与高血压病、2型糖尿病的致病风险相似;女性组:脉压升高与缺血性脑卒中、高血压病的致病风险相似(均P<0.05)。对比分析:女性脉压升高的致病风险较男性高,OR值1.741比1.284(P<0.05)。结论男性脉压≥50 mmHg、女性脉压≥60 mmHg可能是冠心病患病新的危险因素之一,且女性的致病风险高于男性。

Objective To explore the relationship between elevation of brachial pulse pressure and coronary heart disease in different genders.Methods A total of 5116 inpatients with suspected stable coronary heart disease were consecutively enrolled from December 2011 to June 2017 in the Affiliated Hospital of Chengde Medical College,and divided into coronary heart disease group(n=3694)and non-coronary heart disease group(n=1422).The clinical data of all inpatients were collected.A binary logistic regression model of coronary heart disease in different genders were separately established.Results The morbidity of hypertension,dyslipidemia,type 2 diabetes,ischemic stroke and elevated pulse pressure were all higher in the coronary heart disease group than those in the non-coronary heart disease group(all P<0.05).The area under curve(AUC)of pulse pressure in the male group was 0.540,with an optimal diagnostic threshold of 50 mmHg.The AUC of pulse pressure in the female group was 0.612,with an optimal diagnostic threshold of 60 mmHg.Besides hypertension,type 2 diabetes,increase of low-density lipoprotein cholesterol,ischemic stroke,smoking,and aging,elevated pulse pressure was also an independent risk factor for coronary heart disease in both male and female groups(all P<0.05).Additionally,the risk of elevated pulse pressure for coronary heart disease was higher in female group than that of male group(odds ratio(OR):1.741 vs 1.284,P<0.05).Conclusion Elevated pulse pressure may be a new risk factor for coronary heart disease,and its risk for coronary heart disease is higher in women than in men.