动态动脉硬化指数与老年外周动脉硬化严重程度的相关性研究

Correlation of ambulatory arterial stiffness index and severity of peripheral atherosclerosis in the elderly

目的 探讨老年外周动脉硬化患者动态动脉硬化指数(AASI)与动脉硬化(AS)严重程度之间的相关性。方法 选取2018年4月至2019年12月吉林省一汽总医院老年医学科的外周AS患者纳入AS组(n=240),按AS严重程度将踝臂指数(ABI)≤0.9分为外周动脉闭塞(PAD)组(n=43),ABI>0.9分为未完全闭塞组(n=197),选择同期老年健康体检者作为对照组(n=69),收集患者一般资料、生化指标、动态血压、下肢动脉超声等资料。结果 AS组与对照组比较,体重指数、血钙、血尿酸、血镁、总胆固醇、低密度脂蛋白-C、载脂蛋白A、超敏C反应蛋白、AASI、性别、糖尿病病史、原发性高血压病史差异有统计学意义(P <0.05);罹患外周AS危险因素的贡献值依次为AASI、血镁、低密度脂蛋白-C、超敏C反应蛋白;AASI评估AS的截断值为0.469;PAD组与未完全闭塞组AASI比较,差异有统计学意义(P <0.05)。结论 AASI是老年外周AS疾病的独立危险因素,随外周AS严重程度增加而增高。

Objective To investigate the correlation between ambulatory arterial stiffness index(AASI) and severity of atherosclerosis(AS) in elderly patients with peripheral AS(PAS). Methods Patients with peripheral AS from the Department of Geriatrics, Jilin Province Faw General Hospital from April 2018 to December 2019were enrolled in the AS group(n=240). According to the severity of AS, the ankle brachial index(ABI) ≤ 0.9was divided into peripheral artery occlusion group(n=43) and incomplete occlusion group(n=197)(ABI > 0.9).Elderly healthy subjects at the same period were selected as the control group(n=69). The elderly subjects who passed health examination were selected as the control group. General data, biochemical indexes, ambulatory blood pressure, and lower limb arterial ultrasound results and other relevant data were collected from patients.Results There were statistically significant differences between the AS group and the control group in body mass index, blood calcium, blood uric acid, blood magnesium, total cholesterol, low-density lipoproteincholesterol(LDL-C), apolipoprotein A, high-sensitivity C-reactive protein(hs-CRP), AASI, female, history of diabetes mellitus, and history of primary hypertension(P < 0.05). The contribution values of risk factors for developing PAS were AASI, blood magnesium, LDL-C, and hs-CRP in order. The cut-off point for AASI in assessing AS was 0.469. There was a statistically significant difference between the PAD group and the incomplete occlusion group in AASI(P < 0.05). Conclusion AASI is an independent risk factor for PAS in the elderly, which increases with the severity of PAS.