骨关节炎患者动脉僵硬度评估及相关影响因素分析

Assessment of Arterial Stiffness and Related Affecting Factors in Patients with Osteoarthritis

目的评估骨关节炎(osteoarthritis,OA)患者的动脉僵硬度“金标准”指标—颈-股脉搏波传播速度(pulse wave velocity,PWV)并分析相关影响因素。方法纳入2021年5月至2021年12月在东部战区总医院秦淮医疗区骨科就诊的膝关节OA患者(病例组)及同期年龄、身高、体重匹配的非OA志愿者(对照组)共82例。其中病例组41例,男23例,女18例;年龄45~70岁,平均(60.54±7.01)岁。对照组41例,男22例,女19例;年龄45~70岁,平均(59.57±7.57)岁。研究对象的颈-股PWV采用一种基于超声多普勒的无创自动测量技术完成。结果病例组的颈-股PWV为(9.24±1.84)m/s,对照组为(8.25±1.25)m/s,与对照组相比,病例组的颈-股PWV显著升高(P=0.006)。病例组的总胆固醇、收缩压均显著高于对照组(P<0.05)。多因素线性回归模型校正年龄、收缩压、总胆固醇后,颈-股PWV在OA患者中依然显著升高(P=0.024),此外,年龄、收缩压也是动脉僵硬度升高的独立影响因素。结论膝关节OA患者的动脉僵硬度显著升高,疾病本身、年龄、收缩压是其独立影响因素。动脉僵硬度升高可能在OA患者显著增高的心血管系统疾病中发挥了重要作用。

Objective To evaluate the carotid-femoral pulse wave velocity(cfPWV),the “gold standard” of arterial stiffness in patients with osteoarthritis(OA)and explore the related influencing factors.Methods 82 subjects were studied.41 patients with knee OA admitted to the Qinhuai Medical Area of General Hospital of Eastern Theater Command from May to December, 2021 were included in the OA group and 41 age, height and weight matched non-OA volunteers were included in the control group.There were 23 males and 18 females in the patient group.The patients aged from 45 to 70 years old, with an average age of(60.54±7.01)years.The control group included 22 males and 19 females, and aged from 45 to 70 years old, with an average age of(59.57±7.57)years.The cfPWV of each subject was measured by a non-invasive automatic measurement technology based on ultrasound doppler.Results The cfPWV measurements of the OA patients were(9.24±1.84)m/s, the cfPWV of the control group were(8.25±1.25)m/s.Compared with the control group, the OA patients had significantly higher cfPWV(P=0.006).The patient group showed significantly higher total cholesterol and systolic blood pressure than the control group(P<0.05).After adjustment for age, systolic blood pressure and total cholesterol, the multifactor linear regression model showed cfPWV was still significantly increased in OA patients(P=0.024).In addition, age and systolic blood pressure were also independent influencing factors for the increased arterial stiffness.Conclusion The arterial stiffness of knee OA patients was significantly increased, independently affected by OA,age and systolic blood pressure.The increased arterial stiffness may play an important role in the increased cardiovascular diseases in OA patients.