臂踝脉搏波传导速度与全因死亡的关系

Relationship between brachial-ankle pulse wave velocity and all-cause death

目的 探讨臂踝脉搏波传导速度(baPWV)与全因死亡的关系。方法 将2006、2008、2010、2012、2014、2016年度完成开滦集团员工健康体检且完成baPWV检查者作为研究对象,排除既往房颤病史人群,血压资料不全人群,最终39 916例纳入分析。根据baPWV的三分位数将人群分为三组,分别为第一分位组、第二分位组、第三分位组。采用Kaplan-Meier法计算各分位组全因死亡事件的累计发生率,并用Log-Rank检验比较各分位组全因死亡事件的累计发生率的差异,用Cox比例风险模型分析不同分位组baPWV对全因死亡事件的影响。结果 平均随访(5.13±2.36)年,共发生全因死亡事件996例。第一分位组、第二分位组、第三分位组全因死亡事件累计发生率分别为1.12%、3.20%、11.26%,经Log-Rank检验,各分位组间的终点事件累计发生率差异均有统计学意义(P<0.01)。Cox回归分析显示,校正其他混杂因素后,第三分位组发生全因死亡事件是第一分位组的1.97倍(HR=1.97,95%CI:1.50~2.59,P<0.01)。按性别分层,校正其他混杂因素后,男性第三分位组发生全因死亡事件是第一分位组的2.21倍(HR=2.21,95%CI:1.71~2.84,P<0.01)。女性第三分位组发生全因死亡事件是第一分位组的2.74倍(HR=2.74,95%CI:1.20~6.23,P<0.05)。结论 臂踝脉搏波传导速度是全因死亡的独立危险因素。

Objective To discuss the relationship between brachial-ankle pulse wave velocity(baPWV) and all-cause death.Methods The employees of Kailuan Group who completed health and baPWV examinations of in 2006,2008,2010,2012,2014 and 2016 were chose as the subjects in this study.The cases with previous history of atrial fibrillation and incomplete blood pressure data were excluded,and finally 39 916 cases were included.All cases were divided,according to the third quartile of baPWV,into first-quartile group,second-quartile group and third-quartile group.The cumulative incidence rates of all-cause death events were calculated in all groups by using Kaplan-Meier method,and difference in cumulative incidence rates of all-cause death events were compared in all groups by using Log-Rank test.The influence of baPWV on all-cause death events was analyzed by using Cox proportional hazard model in all groups.Results All cases were averagely followed up for(5.13±2.36) years and all-cause death events were occurred in 996 cases.The cumulative incidence rates of all-cause death events were 1.12% in first-quartile group,3.20% in second-quartile group,and 11.26% in third-quartile group,and the results of Log-Rank test showed that the difference in cumulative incidence rates of endpoint events had statistical significance among all groups(P<0.01).The results of Cox regression analysis showed that incidence rates of allcause death events were 1.97 times higher in third-quartile group than those in first-quartile group(HR=1.97,95%CI:1.50~2.59,P<0.01) after correcting other confounding factors.Stratified by genders,incidence rates of allcause death events in male cases were 2.21 times higher in third-quartile group than those in first-quartile group(HR=2.21,95%CI:1.71~2.84,P<0.01),and incidence rates of all-cause death events in female cases were 2.74times higher in third-quartile group than those in first-quartile group(HR=2.74,95%CI:1.20~6.23,P<0.05) after correcting other confounding factors.Conclusion BaPWV is an independent risk factor of all-cause death.