外周大动脉弹性、胰岛素抵抗、血清Hcy和hs-CRP对心血管疾病筛查的临床意义

The clinical significance of peripheral aortic elasticity,insulin resistance,serum Hcy and hs-CRP in screening of cardiovascular disease

目的 通过检测健康体检人群外周大动脉弹性、胰岛素抵抗、血清同型半胱氨酸(Hcy)和高敏C反应蛋白(hs-CRP)水平,为早期筛查心血管疾病高危人群提供客观指标。方法 选取1250例体检者中心血管疾病者375例(观察组)和无心血管疾病者875例(对照组)。比较两组脉搏波传导速度(PWV)、踝肱指数(ABI)、颈动脉内膜中膜厚度(IMT)、斑块形成以及硬度指数(β),计算胰岛素抵抗指数(HOMA-IR),检测Hcy和hs-CRP水平,采用Pearson相关性分析法分析PWV、ABI、HOMA-IR、Hcy、hs-CRP与IMT、β的相关性。结果 与对照组比较,观察组PWV和ABI增加,IMT增加,斑块形成率增多,β升高,HOMA-IR增加,血Hcy和hs-CRP水平升高(P<0.05)。Pearson检验显示,PWV、ABI、HOMA-IR、Hcy、hs-CRP与IMT、β呈正相关(P<0.05)。ROC显示,PWV、ABI、IMT、β、HOMA-IR、Hcy和hs-CRP预测心血管疾病的曲线下面积(AUC值)分别为0.812、0.823、0.865、0.872、0.892、0.816和0.852(P<0.05)。结论 体检人群中合并心血管疾病者外周大动脉弹性、胰岛素抵抗、血Hcy和hs-CRP水平与IMT及β值具有相关性,对心血管疾病的筛查有一定价值。

Aim To detect the peripheral aortic elasticity,insulin resistance,homocysteine(Hcy)and high-sensitivity C-reactive protein(hs-CRP)in healthy people,so as to provide reference indicators for early identification of high-risk groups of cardiovascular disease.Methods A total of 1250 healthy check-up crowds were enrolled,375 persons with cardiovascular disease in observation group and other 875 persons without cardiovascular disease in control group.Pulse wave velocity(PWV),ankle brachial index(ABI),carotid intima-media thickness(IMT),plaque for-mation,and stiffness index(β)were measured,calculate insulin resistance index(HOMA-IR),detect serum Hcy and hs-CRP levels,compare body mass index(BMI),systolic and diastolic blood pressure.The correlation of PWV,ABI,HO-MA-IR,Hcy,hs-CRP with IMT,βwas analyzed by Pearson correlation analysis.Results The PWV and ABI values in observation group were significantly higher than those in control group,what’s more,IMT was larger,plaque formation rate was more,βvalue was higher,HOMA-IR was more,serum Hcy and hs-CRP levels were higher(P<0.05).Pearson test showed that PWV,ABI,HOMA-IR,Hcy,hs-CRP were significantly positively correlated with IMT andβ(P<0.05).The area under curve(AUC)of PWV,ABI,IMT,β,HOMA-IR,Hcy and hs-CRP for predicting cardiovascular disease by receiver operating curve(ROC)were 0.812,0.823,0.865,0.872,0.892,0.816 and 0.852,respectively(P<0.05).Conclusion There are differences in peripheral aortic elasticity,insulin resistance,blood Hcy and hs-CRP levels in the physical examination population with cardiovascular disease,and they are correlated with IMT andβvalues,which have certain value for the screening of cardiovascular disease.