收缩压和舒张压比值与老年肥胖合并高血压患者动脉硬化程度的相关性分析

Correlation between SBP/DBP ratio and atherosclerosis in elderly obesity patients with hypertension

目的探讨收缩压/舒张压比值对老年肥胖合并高血压患者动脉硬化程度的预测价值。方法选择2017年1月~2019年12月山东大学附属临沂市人民医院参加体检的老年肥胖合并高血压患者363例,根据收缩压/舒张压比值分为高值组98例(2.5≥收缩压/舒张压>2.0);对照组219例(2.0≥收缩压/舒张压>1.5);低值组46例(收缩压/舒张压≤1.5)。比较3组一般临床资料,采用logistic回归分析,用ROC曲线进行效果评价。结果高值组、对照组和低值组动脉硬化事件发生率比较,差异有统计学意义(22.4%vs 24.2%vs 13.0%,P=0.016)。Pearson相关性分析显示,收缩压/舒张压比值与踝肱指数呈负相关(r=-0.603,P<0.05),与动脉硬化指数呈正相关(r=0.656,P<0.05)。logistic回归分析显示,脉压、收缩压/舒张压比值、TC、LDL-C、HDL-C、踝肱指数、动脉硬化指数是老年肥胖合并高血压患者的危险因素(P<0.01)。ROC曲线分析显示,收缩压/舒张压比值预测动脉硬化事件的临界值为1.92,敏感性为74.61%,特异性为33.95%,曲线下面积为0.747(95%CI:0.690~0.804),具有良好的预测价值。结论收缩压/舒张压比值与踝肱指数、动脉硬化指数存在显著相关,对老年肥胖合并高血压患者动脉硬化事件的预测评估具有良好应用价值。

Objective To study the value of SBP/DBP ratio for predicting atherosclerosis in elderly obesity patients with hypertension.Methods Three hundred and sixty-three elderly obesity patients with hypertension admitted to the Affiliated Linyi People’s Hospital of Shandong University from January 2017 to December 2019 were divided into high SBP/DBP ratio group(n=98),control group(n=219)and low SBP/DBP ratio group(n=46).Their general clinical data were compared and analyzed by logistic regression analysis.The value of SBP/DBP ratio for predicting atherosclerosis in elderly obesity patients with hypertension was assessed by ROC curve analysis.Results The incidence of atherosclerosis was significantly lower in high SBP/DBP ratio group than in control group and low SBP/DBP ratio group(22.4%vs 24.2%vs 13.0%,P=0.016).Pearson correlation analysis showed that the SBP/DBP ratio was negatively correlated with the ABI(r=-0.603,P<0.05)and positively correlated with the AI(r=0.656,P<0.05).Logistic regression analysis displayed that PP,SBP/DBP ratio,TC,LDL-C,HDL-C,ABI and AI were the risk factors for atherosclerosis in elderly obesity patients with hypertension(P<0.01).ROC curve analysis revealed that the critical value of SBP/DBP ratio for predicting atherosclerosis in elderly obesity patients with hypertension was 1.92 with a sensitivity of 74.61%and a specificity of 33.95%.The AUC for SBP/DBP ratio in predicting atherosclerosis in elderly obesity patients with hypertension was 0.747(95%CI:0.690-0.804).Conclusion SBP/DBP ratio is closely correlated with ABI and AI,and can thuse effectively predict and assess atherosclerosis in elderly obesity patients with hypertension.