Ankle-brachial index and brachial-ankle pulse wave velocity are risk factors for ischemic stroke in patients with type 2 diabetes

The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group （n = 55） and a diabetes and ischemic stroke group （n = 62）. We then performed ABI and BaPWV examinations for all patients. Compared with the diabe- tes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.

Serum Calcium Level is Associated with Brachial-ankle Pulse Wave Velocity in Middle-aged and Elderly Chinese

Objective To study the relation between serum calcium level and elevated BaPWV in Chinese subjects. Methods The relation between serum calcium level and elevated BaPWV was studied in 9 615 subjects. The mean value of left and right BaPWV was analyzed. BaPWV was defined as high when it was31 752.5 cm/s （the upper quartile） either side. Results The BaPWV and its elevated percentage progressively increased across the quartiles of the serum calcium level （P〈0.05）. The prevalence of elevated BaPWV was significantly higher in subjects of the second, third and highest quartiles than in those of the lowest quartile （26.9%, 28.4%, and 33.2%vs 23.7%, P=0.0116, P=0.0004, and P〈0.0001）. Logistic regression analysis revealed that the risk of elevated BaPWV was 1.32- fold higher in subjects of the highest quartile than in those of the lowest quartile （OR=1.32, 95%CI：1.08-1.60）. Conclusion The elevated serum calcium level is related to an elevated BaPWV and a higher risk of arterial stiffness, independent of conventional risk factors, in middle-aged and elderly Chinese subjects.

Relationship between brachial-ankle pulse wave velocity and metabolic syndrome components in a Chinese population

The purpose of this study was to assess the relationship between arterial stiffness, as measured by brachial-ankle pulse wave velocity （baPWV）, and the presence of the metabolic syndrome （MS） in a Chinese population. A total of 4,445 subjects were enrolled. The prevalence of MS in for the general population, males and females, respectively. our study population was 21.7%, 17.2% and 25.6% With adjustments for age, gender, cigarette smoking, heart rate, total cholesterol, low-density lipoprotein （LDL） cholesterol, and the use of anti-hypertensive drug, the stepwise regression analysis showed that baPWV had a significant relationship with components of MS, including systolic blood pressure （P 〈 0.001）, diastolic blood pressure （P 〈 0.001）, glucose （P 〈 0.001）, highdensity lipoprotein （HDL） cholesterol （P = 0.04）, and triglycerides （P 〈 0.001）, but no relationship with waist circumference （P = 0.25）. With an increase in the number of the MS components, baPWV increased significantly both in women and men. This study indicated that the MS is indeed a risk factor for arterial stiffness. Monitoring of baPWV in patients with MS may help in identifying persons at high risk for cardiovascular disease.

Relationship between the Plasma Fibulin-1 Levels,Pulse Wave Velocity,and Vascular Age in Asymptomatic Hyperuricemia

Fibulin-1(FBLN-1),an elastin-associated extracellular matrix protein,has been found in blood and may play a role in the pathophysiological processes leading to cardiovascular disease(CVD).We aimed to investigate the relationship between fibulin-1 levels and the risk of CVD by evaluating vascular age derived from the Framingham Heart Study and brachial-ankle Pulse Wave Velocity(baPWV)in patients with asymptomatic hyperuricemia(AHU).In total,66 patients with AHU and 66 gender-and age-matched healthy individuals were enrolled.The plasma fibulin-1 levels were measured by immunochemistry.Patients with AHU presented significantly higher vascular age[median(interquartile range):54(22)vs.48(14)years,P=0.01]and baPWV[mean±SD:1373±223 vs.1291±177 cm/s,P=0.02]than the healthy subjects;however,no significant difference was observed in the plasma fibulin-1 level between the patients with AHU and healthy subjects[median(interquartile range):4018(3838)vs.3099(3405)ng/mL,P=0.31].A correlation between fibulin-1 levels and baPWV was observed only in patients with AHU(r=0.29,P=0.02);and there was also a suggestively statistically significant correlation between fibulin-1 levels and vascular age(r=0.22,P=0.08).However,these associations were rendered insignificant after adjustments for potential confounders.In healthy subjects,no correlation was observed between fibulin-1 levels and CVD risk.This study reveals that plasma fibulin-1 levels may reflect the CVD risk in patients with AHU,but the relationship is not robust.

Increased brachial-ankle pulse wave velocity is associated with impaired endothelial function in patients with coronary artery disease

Background Pulse wave velocity and flow-mediated vasodilation （FMD） are widely used as noninvasive modalities for evaluating atherosclerosis. However, it is not known whether pulse wave velocity is related to FMD in patients with coronary artery disease （CAD）. Therefore, the present study was designed to investigate the alteration in brachial-ankle pulse wave velocity （baPWV） and endothelial function in CAD patients. Methods Thirty-three patients with CAD and thirty control subjects were recruited for this study, baPWV was measured non-invasively using a VP 1000 automated PWV/ABI analyzer （PWV/ABI, Colin Co. Ltd., Komaki, Japan）. Endothelial function as reflected by FMD in the brachial artery was assessed with a high-resolution ultrasound device. Results baPWV was increased in CAD patients compared with control subjects [（1756.1±253.1） cm/s vs （1495.3±202.3） cm/s, P〈0.01]. FMD was significantly reduced in CAD patients compared with control subjects [（5.2±2.1） % vs （11.1±4.4） %, P〈0.01]. baPWV correlated with FMD （r =-0.68, P〈0.001）. The endothelium-independent vasodilation induced by sublingual nitroglycerin in the brachial artery was similar in the CAD group compared with the control group.Conclusions CAD is associated with increased baPWV and endothelial dysfunction. Increased baPWV parallels diminished endothelial function. Our data therefore suggest that baPWV can be used as a noninvasive surrogate index in clinical evaluation of endothelial function.

Reference values of brachial-ankle pulse wave velocity for Northern Chinese

Background Brachial-ankle pulse wave velocity （baPWV） is a reliable method for measuring arterial elasticity, but the absence of reference value for baPWV has limited its wide use. We conducted an epidemical study in north China to investigate the reference value of baPWV for Chinese people and its influential factors. Methods A total of 974 identified healthy subjects were recruited in this study. The values of baPWV were evaluated noninvasively with an automatic device. Results For healthy population, the mean value of baPWV was higher for male （P 〈0.001）. Multiple regression analysis demonstrated that both age and systolic blood pressure were positively associated with baPWV for male and female （P 〈0.001）. BaPWV value was higher in male than in female in younger group （〈50 years） but not in older group （P〈-0.001）. The upper limits of baPWV were 1394/1264 cm/s, 1435/1361 cm/s, 1552/1433 cm/s, 1597/1609 cm/s and 1798/1915 cm/s for healthy male/female at 10 years interval （age range 20-70 years）. Conclusions Aging is the most important reason of arterial stiffness, but the effect of age on baPWV augmentation is greater for healthy female than their male counterpart. The reference values of baPWV by sex and age are very useful for clinical and preventive medicine.

Can we early diagnose metabolic syndrome using brachial-ankle pulse wave velocity in community population？

Background The prevalence of metabolic syndrome （MetS） increased recently and there was still not a screening index to predict MetS.The aim of this study was to estimate whether brachial-ankle pulse wave velocity （baPVVV）,a novel marker for systemic arterial stiffness,could predict MetS in Chinese community population.Methods A total of 2 191 participants were recruited and underwent medical examination including 1 455 men and 756 women from June 2011 to January 2012.MetS was diagnosed according to the criteria of the International Diabetes Federation （IDF）.Multiple Logistic regressions were conducted to explore the risk factors of MetS.Receiver operating characteristic （ROC） curve was performed to estimate the ideal diagnostic cutoff point of baPWV to predict MetS.Results The mean age was （45.35±8.27） years old.In multiple Logistic regression analysis,the gender,baPWV and smoking status were risk factors to MetS after adjusting age,gender,baPWV,walk time and sleeping time.The prevalence of MetS was 17.48% in 30-year age population in Shanghai.There were significant differences （Х^2=96.46,P 〈0.05） between male and female participants on MetS prevalence.According to the ROC analyses,the ideal cutoff point of baPWV was 1 358.50 cm/s （AUC=60.20%） to predict MetS among male group and 1 350.00 cm/s （AUC=70.90%） among female group.Conclusion BaPWV may be considered as a screening marker to predict MetS in community Chinese population and the diagnostic value of 1 350.00 cm/s was more significant for the female group.

New definition of metabolic dysfunction-associated fatty liver disease with elevated brachial-ankle pulse wave velocity and albuminuria: a prospective cohort study

A new definition of metabolic dysfunction-associated fatty liver disease(MAFLD)has recently been proposed.We aim to examine the associations of MAFLD,particularly its discordance from non-alcoholic fatty liver disease(NAFLD),with the progression of elevated brachial-ankle pulse wave velocity(baPWV)and albuminuria in a community-based study sample in Shanghai,China.After 4.3 years of follow-up,778 participants developed elevated baPWV and 499 developed albuminuria.In comparison with the non-MAFLD group,the multivariable adjusted odds ratio(OR)of MAFLD group for new-onset elevated baPWV was 1.25(95%confidence interval(CI)1.01–1.55)and 1.35(95%CI 1.07–1.70)for albuminuria.Participants without NAFLD but diagnosed according to MAFLD definition were associated with higher risk of incident albuminuria(OR 1.77;95%CI 1.07–2.94).Patients with MAFLD with high value of hepamet fibrosis score or poor-controlled diabetes had higher risk of elevated baPWV or albuminuria.In conclusion,MAFLD was associated with new-onset elevated baPWV and albuminuria independently of body mass index,waist circumference,and hip circumference.Individuals without NAFLD but diagnosed as MAFLD had high risk of albuminuria,supporting that MAFLD criteria would be practical for the evaluation of long-term risk of subclinical atherosclerosis among fatty liver patients.

肥胖儿童臂-踝脉搏波传导速度影响因素分析

目的:探索肥胖儿童臂-踝脉搏波传导速度(baPWV)的改变,并分析其影响因素。方法:选择2021年6月至2022年10月于苏州大学附属儿童医院内分泌遗传代谢科及儿童保健科就诊的94例肥胖儿童和57例体检健康儿童。比较两组BMI、性别、年龄、血尿酸、血脂、空腹血糖和胰岛素、颈动脉内膜中层厚度(cIMT)、baPWV、BMI的Z分数(Z-BMI)、收缩压(SBP)、舒张压(DBP)、稳态模型胰岛素抵抗指数(HOMA-IR)等的差异。比较肥胖儿童中高血压组和正常血压组、青春期组和青春期前组baPWV的差异。采用多重线性回归分析baPWV的影响因素。结果:肥胖儿童的baPWV慢于健康儿童(P=0.036)。肥胖儿童中,高血压组的baPWV快于正常血压组,青春期组快于青春期前组(P<0.05)。多重线性回归分析结果显示DBP和HOMA-IR是肥胖儿童baPWV的影响因素,B(95%CI)为10.959(4.745~17.173)和3.416(0.771~6.061)。结论:肥胖儿童baPWV与血压、HOMA-IR、青春期有关。

甘油三酯-葡萄糖指数与颈动脉结构和弹性功能关联性及中介效应

目的探讨一般成年人群甘油三酯-葡萄糖指数(triglyceride-glucose index,TyG)与颈动脉结构和弹性功能的关系。方法选取2021年6月~2021年12月期间在唐都医院进行年度体检的健康志愿者的临床超声资料,进行横断面研究,共纳入志愿者594例。根据TyG指数水平的三分位数范围分为3组:T1组(4.24±0.10),T2组(4.45±0.06),T3组(4.71±0.11),各组人数均为198。通过多元线性模型估计TyG指数,颈动脉内中膜厚度(carotid intima-media thickness,CIMT)与脉搏波传导速度(pulse wave velocity,PWV)之间的关系。采用中介效应分析身体质量指数(body mass index,BMI)、血压、血糖和血脂指标在TyG指数与CIMT及PWV关联性中的中介作用。结果随着TyG指数水平的升高,调查对象各项数据依组逐次变化,T1、T2与T3组吸烟的比例逐次升高并有统计学差异,相邻组及跨组比较均P<0.05;年龄、女性比例、BMI、总胆固醇、低密度脂蛋白胆固醇、甘油三酯、空腹血糖、饮酒比例、CIMT与PWV逐渐增高,高密度脂蛋白胆固醇逐渐减低,相邻组及跨组比较均P<0.01。多元线性回归分析发现,调整协变量后,TyG指数每增加1个单位,CIMT增加0.54μm(95%CI:0.13~0.64;P<0.01),PWV增加0.28 m/s(95%CI:0.20~0.37;P<0.01)。中介效应分析发现,SBP以间接介导的方式对PWV产生正向影响,其中介效应占比为18.2%。结论TyG指数是正常成年人群CIMT及PWV的独立危险因素。TyG指数通过SBP介导以间接方式与PWV呈正相关。

健步走锻炼对早期冠心病患者脉搏波传导速度和血浆同型半胱氨酸水平的影响

为了探讨健步走锻炼对早期冠心病患者肱-踝脉搏波传导速度(baPWV)和血浆同型半胱氨酸(Hcy)水平的影响,将40例早期冠心病患者分为健步走组(30例)和对照组(10例),健步走组再分为一周三次组(10例)、一周二次组(10例)和一周一次组(10例),测定锻炼前后患者同型半胱氨酸、baPWV的水平,得出对照组患者的血糖、总胆固醇、同型半胱氨酸和baPWV等水平均高于健步走组(P<0.05);健步走次数越少,同型半胱氨酸、baPWV的水平越高.结果表明早期冠心病患者的同型半胱氨酸、baPWV水平与锻炼次数呈现正相关,由此说明,同型半胱氨酸、baPWV水平表达的高低可用于评估早期冠心病患者锻炼的疗效.

高血压动脉弹性功能与血压控制程度的相关性研究

目的探讨高血压动脉弹性功能与血压控制程度相关性。方法将2022年1—12月在福建省三明市中西医结合医院心内科治疗的80例原发性高血压(essential hypertension,EH)患者作为研究对象,根据高血压分级标准进行分组,A组1级EH(n=30),B组2级EH(n=25),C组3级EH(n=25),将同期50名健康体检者作为D组。对比四组的动脉弹性各指标、不同脉压EH的动脉弹性各指标与血压及脉压的相关性。结果A组、B组、C组肱踝脉搏波传导速度(brachial-ankle pulse wave conduction velocity,BaPWV)、踝肱指数(anklebrachial index,ABI)高于D组(P<0.05);≥80 mmHg脉压患者BaPWV、ABI指标与其他亚组比较,差异有统计学意义(P<0.05);Pearson相关分析显示,BaPWV、ABI与血压分级呈轻度正相关(P<0.05),与脉压中至高度呈正相关(P<0.05)。结论EH动脉弹性功能与脉压呈负相关,脉压越高,动脉弹性越差,引发心血管疾病的风险越高,临床应加强脉压监测,早期防治脉压升高。

血浆致动脉硬化指数与臂-踝脉搏波传导速度在早发冠心病发生及其冠状动脉病变程度中的评估价值

目的探讨血浆致动脉硬化指数(AIP)与臂-踝脉搏波传导速度(ba-PWV)在早发冠心病(PCAD)的发生及其冠状动脉病变程度中的评估价值。方法收集2020年12月至2021年12月因胸痛疑诊冠心病在新疆医科大学第一附属医院住院行冠状动脉造影(CAG)检查且男性<55岁,女性<65岁的患者336例,根据CAG确诊早发冠心病(PCAD)组163例,其中急性冠状动脉综合征92例(56.4%),稳定型冠心病71例(43.6%),未达冠心病诊断标准的173例患者设为对照组。又根据Gensini评分分为A组(0分)129例、B组(1-14分)126例、C组(>14分)81例。对各组间一般临床资料与相关实验室检查进行统计学分析。采用logistic回归模型筛选PCAD的独立危险因素,并进一步分析AIP及ba-PWV对PCAD的诊断价值。结果与对照组相比,PCAD组AIP、ba-PWV等均明显偏高,差异具有统计学意义(P<0.05)。相关分析显示,AIP、ba-PWV与Gensini评分均呈正相关(rs分别为0.321、0.440,均P<0.05)。Logistic多因素回归分析显示,ba-PWV、AIP、吸烟、糖尿病、Hcy等均为PCAD的独立危险因素(均P<0.05);以AIP联合ba-PWV绘制的ROC曲线下面积为0.780(95%CI 0.730~0.830,P<0.05),敏感度和特异度分别为70.60%、77.50%。结论AIP及ba-PWV均为PCAD的独立危险因素,二者联合时可以提高诊断PCAD的敏感度,且二者与冠状动脉病变程度均呈正相关。

不同性别老年人体成分与臂-踝脉搏波传导速度的相关性研究

目的 探讨不同性别老年人体成分与臂-踝脉搏波传导速度(baPWV)之间的关系。方法 连续纳入2021年1~12月蚌埠市东风社区参加社区健康体检的老年人1703例,使用人体成分分析仪和全自动动脉硬化检测仪分别测定体成分和baPWV。结果 1703例老年人中,检出动脉硬化者(baPWV≥14.0 m/s)1452例,检出率为85.3%。Pearson相关分析显示,老年女性的腰围(WC)、BMI、身体圆度指数(BRI)、总水分(TBW)、体脂率(%BF)和总脂肪量(TFM)与baPWV呈正相关,上肢肌肉量比值(RAMM)、上肢无脂肪量比值(RAFFM)、下肢肌肉量比值(RLMM)、下肢无脂肪量比值(RLFFM)、躯干肌肉量比值(RTMM)和躯干无脂肪量比值(RTFFM)与baPWV呈负相关;老年男性只有%BF与baPWV呈正相关。多元线性逐步回归分析显示,SBP、年龄、心率(HR)、%BF是老年男性baPWV的主要影响因素;SBP、年龄、HR、%BF、RTMM、BMI、TFM、脉压差(PP)是老年女性baPWV的主要影响因素。结论 社区老年人动脉硬化的发生率处于高水平,老年女性体成分指标对baPWV的影响更大。

原发性高血压患者baPWV与PRC、PAC、ARR的相关性研究

目的探讨原发性高血压(essential hypertension,EH)患者臂踝脉搏波传导速度(brachial and ankle pulse wave conduction velocity,baPWV)与血浆肾素浓度(plasmaren in concentration,PRC)、血浆醛固酮浓度(plasma aldosterone concentration,PAC)及醛固酮/肾素(aldosterone to renin ratio,ARR)的相关性。方法随机收集2021年3~4月参与云南省安宁市“中国居民心血管病及其危险因素监测”项目的研究对象208例,根据有无EH将研究对象分为非EH组和EH组,分别采集两组的基本资料、血生化、PRC、PAC、ARR及baPWV等指标。采用Spearman相关性分析评价EH患者baPWV与PRC、PAC、ARR的相关性。结果两组体重指数(bogymass index,BMI)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、PRC、ARR、baPWV比较,差异均有统计学意义。Spearman相关性分析结果显示,baPWV与PRC(r=-0.148,P=0.131)、PAC(r=0.095,P=0.333)均无相关性,而baPWV与ARR(r=0.095,P=0.027)呈正相关。结论EH患者baPWV与PRC、PAC无显著相关性,与ARR呈正相关,ARR可作为动脉粥样硬化的预测指标和影响因素。

高血压患者运动血压与高敏C-反应蛋白和脉搏波传导速度的相关性分析

目的观察原发性高血压患者运动时血压水平与高敏C反应蛋白(hs-CRP)和踝臂脉搏波传导速度(BaPWV)的相关性。方法选择高血压病1、2级患者共80例,均行血脂、血糖、hs-CRP和BaPWV检测,然后所有受试者均接受运动平板试验,分别测量运动前、运动亚极量、运动后的血压情况,按照运动高血压的标准,将受试者分为运动高血压组(H组)和运动血压正常组(N组),比较两组间收缩压(SBP)、舒张压(DBP)、脉压(PP)、hs-CRP和BaPWV等指标,以及运动血压水平与hs-CRP、BaPWV的相关性。结果 H组hs-CRP浓度和BaPWV值[(8.42±3.82)mg/L、(19.84±8.13)m/s]均高于N组[(6.64±4.12)mg/L、(15.71±9.24)m/s](均P<0.05),并与运动亚极量时SBP、PP水平具有相关性(hs-CRP与SBP、PP,r=0.26、0.25,均P<0.05;BaPWV与SBP、PP,r=0.29、0.36,P<0.05或0.01)。结论运功高血压患者较运动血压正常者炎症反应和动脉硬化程度更明显,对运动高血压的早期发现和积极干预,可能在一定程度上能改善高血压患者的预后。

冠心康方加减联合西药治疗冠心病合并2型糖尿病气虚痰瘀证疗效研究

目的:探讨冠心康方加减联合西药治疗冠心病合并2型糖尿病气虚痰瘀证的疗效。方法:选择冠心病合并2型糖尿病患者98例,按随机数字表法分为对照组47例和观察组51例。对照组给予西医常规治疗措施;观察组在对照组治疗基础上加用冠心康方加减治疗,1剂/次,2次/d。连续治疗6个月后,比较两组血糖血脂水平、中医证候评分、脉搏波传导速度(PWV)以及临床疗效。结果:治疗后,观察组的空腹血糖(6.71±1.04)mmol/L、餐后2 h血糖为(10.63±1.94)mmol/L、HbA1c(7.13±0.97)%、TG(2.50±0.40)mmol/L,TC(3.94±0.55)mmol/L均低于对照组[(6.89±1.13)mmol/L、(10.93±2.03)mmol/L、(7.22±1.25)%、(2.53±0.36)mmol/L、(4.01±0.53)mmol/L],两组间比较差异有统计学意义(P<0.05)。治疗后观察组HDL-C(1.23±0.22)mmol/L与对照组(1.19±0.21)mmol/L比较上升,而观察组LDL-C(2.61±0.34)mmol/L比对照组(2.67±0.37)mmol/L下降,组间比较差异无统计学意义(P>0.05)。治疗后,观察组患者中医证候评分(1.76±0.27)分及BS-PWV(5.90±0.64)m/s、ES-PWV(7.59±0.94)m/s均明显低于对照组的[(2.13±0.31)分、(6.41±0.77)m/s、(8.43±1.31)m/s](P<0.05)。观察组和对照组的总有效率分别为70.59%和59.57%,两组比较差异有统计学意义(P<0.05)。结论:冠心康方加减联合西药治疗冠心病合并2型糖尿病气虚痰瘀证可有效改善患者的血糖、血脂、中医证候以及动脉硬化,提高临床疗效。

超声联合CT引导定位双极脉冲射频缓解神经根型颈椎病患者疼痛的作用分析

目的:探讨并分析超声联合CT引导定位双极脉冲射频缓解神经根型颈椎病患者疼痛的作用,以有效提高颈椎病的治疗效果。方法:选择医院诊治的126例神经根型颈椎病患者,采用随机数表法将其分为观察组和对照组,每组63例。观察组采用彩色超声仪,22 G射频针给予双极脉冲射频治疗;对照组给予硬膜外注射镇痛治疗。对比两组治疗总有效率,肌电图颈神经F波传导速度,以及并发症发生情况;采用疼痛数字评级量表(NRS)评分,分析两组患者的疼痛变化情况。结果:两组患者治疗过程中均无严重并发症发生;观察组治疗总有效率为98.4%,显著高于对照组(88.9%),差异有统计学意义(x^(2)=4.805,P<0.05)。观察组治疗第1周和第4周的NRS评分均显著低于对照组,差异有统计学意义(t=8.822,t=6.922;P<0.05)。观察组和对照组治疗后患者的肌电图F波传导速度均显著高于治疗前,差异有统计学意义(t=11.945,t=6.292;P<0.05);治疗后观察组患者颈神经F波传导速度显著高于对照组,差异有统计学意义(t=5.333,P<0.05)。结论:超声联合CT双极脉冲射频能持续促进缓解神经根型颈椎病患者的疼痛状况,加快肌电图F波传导速度,从而提高治疗效果。

高血压病血管健康维护防治研究

目的高血压病患者血管健康维护,动脉粥样硬化的预防,应从血管病变的早期抓起,探讨降压治疗对血管健康维护的重要性。方法研究人群为我院2007～2010年以来的门诊及住院的高血压病患者,在12个月治疗高血压病的同时,治疗前后进行血压监测[包括收缩压(SBP)、舒张压(DBP)、脉压(PP)]、脉搏波传导速度(PWV)、心踝血管指数(CAVI)、踝臂指数(ABI)、颈总动脉内中膜厚度(IMT)及动脉僵硬系数(β),同时常规检测心电图、肾功、血脂、血糖等指标变化。并按照不同年龄段分组(共5组,分别为<40岁组、40～49岁组、50～59岁组、60～69岁组、≥70岁组)进行统计分析。结果各组治疗后SBP和DBP显著下降(P<0.001),PP缩小(P<0.001),血脂、血糖、肾功均无明显变化。PWV减慢(P<0.001)、CAVI下降(P<0.05)、ABI升高(P<0.05)、IMT变薄(P<0.05),β降低(P<0.01)。结论高血压病患者的动脉血管健康维护,从各个年龄组统计指标来看,降压治疗能够改善动脉功能,防治或延缓动脉粥样硬化的发生。

尿微量蛋白、臂-踝脉搏波传导速度与老年隐蔽性高血压的相关性研究

目的 探讨尿微量蛋白(microalbuminuria,MA)、臂-踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)与老年隐蔽性高血压(masked hypertension,MH)的关系。方法 在参加2010至2011年度健康体检的开滦离退休员工中整群抽取年龄≥60岁的人群2814例于2012至2014年进行动态血压监测,符合入选标准者2464例,分析其中448例诊室血压正常老年人MA、baPWV与MH的关系。结果 448例观察对象患者中MH 188例。其中,单纯白天MH 10例(5.3%),单纯夜间MH 119例(63.3%),白天和夜间MH 59例(31.4%)。与正常血压组相比,白天和夜间MH组的MA升高(P<0.05);单纯白天MH、单纯夜间MH、白天和夜间MH组baPWV增快(P<0.05)。回归结果显示,MA>30 mg/L与总人群MH和男性MH正相关,OR值分别是2.016(95%CI 1.076~3.779)、2.886(95%CI 1.271~6.554),与女性MH无关。baPWV≥1554 cm/s与总人群MH、男性MH、女性MH正相关,OR值分别为3.249(95%CI 2.084~5.064)、4.163(2.340~7.406)、2.378(95%CI 1.197~4.727)。结论 老年单纯白天MH、单纯夜间MH、白天和夜间MH比例分别为5.3%、63.3%和31.4%,尿微量蛋白>30 mg/L、baPWV>1554 cm/s与老年MH正相关。