桡动脉反射波增强指数与其他动脉硬化指标的关系

摘要/Abstract

摘要： 目的：探讨桡动脉反射波增强指数(augmentation index, AI)与其他动脉硬化无创检测指标之间的相关性。方法：选择2010年4~6月参加北京市石景山区两社区横断面调查者1 752名，年龄23~90岁。采用无创检测设备分别测量AI、臂踝脉搏波传导速度(brachial-ankle pulse wave velocity, baPWV)、踝臂指数(ankle-brachial index, ABI)和颈动脉内-中膜厚度(intima-media thickness, IMT)，分析指标之间的相关性。结果：baPWV≥14 m/s、ABI≤0.9 和IMT≥0.9 mm组的AI₇₅（心率为75次/分钟时的标准校正值）与对照组相比差异无统计学意义(P>0.05)。高血压病患者的baPWV显著高于健康对照组，老年高血压病合并糖尿病或(和)血脂异常者的ABI显著低于健康对照组，而AI₇₅值在不同疾病组间差异无统计学意义。简单相关分析发现，AI₇₅与女性、中心动脉收缩压、总胆固醇、低密度脂蛋白、高密度脂蛋白呈正相关，与体质量指数、腰臀比、甘油三酯、空腹血糖呈负相关，与年龄不相关(r=0.045, P=0.064)。AI₇₅与ABI、IMT呈负相关，男性的AI₇₅与baPWV呈正相关(r=0.101, P=0.005)。偏相关分析发现，AI₇₅与ABI、baPWV、IMT呈负相关，女性和男性的AI₇₅与baPWV、IMT呈负相关，与ABI不相关 (P>0.05)。多因素逐步回归分析发现，AI₇₅的独立正相关因素为女性、年龄、腰臀比、中心动脉收缩压，负相关因素为体质量指数、身高、空腹血糖 (R²=0.372)。结论：桡动脉AI与动脉硬化指标缺乏相关性，评估动脉硬化程度尚缺乏敏感性和可靠性。

关键词: 挠动脉, 血管疾病, 动脉粥样硬化, 增强指数

Abstract: To investigate the relationship between radial augmentation index (AI) and other noninvasive indices for evaluating arteriosclerosis. Methods: From April to June 2010, a cross-sectional survey was performed in two communities of Shijingshan District, Beijing, China. This study involved 1 752 subjects (aged 23 to 90 years). AI was measured using Colin pulse wave detection device HEM9000AI. Brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) were measured using Colin noninvasive arteriosclerosis tester VP-1000．Color Doppler flow imaging was used to measure intima-media thickness (IMT) of the bilateral carotid arteries. Results: Compared with the control group, baPWV≥14 m/s, ABI≤0.9 and IMT≥0.9 mm groups showed no significant difference in AI₇₅ (P>0.05). Hypertensive individuals had significantly higher baPWV than the healthy group. Elderly hypertensive individuals with diabetes mellitus or (and) dyslipidemia had lower ABI than the control group. There was no significant difference of AI₇₅ between the disease groups and the healthy group (P>0.05). Pearson correlation analysis showed that AI₇₅ was associated with women, central aortic systolic pressure, total cholesterol, low-density lipoprotein, high-density lipoprotein, and inversely associated with body mass index, waist hip ratio, triglycerides, fasting serum glucose, and not associated with age (r=0.045, P=0.064). There was negative correlation between AI₇₅ and ABI, IMT. AI₇₅ was positively correlated with baPWV in the male group (r=0.101, P=0.005), but not correlated in the female group. Partial correlation analysis found that AI₇₅ was inversely associated with ABI, baPWV and IMT. There was negative correlation between AI₇₅ and baPWV, IMT in the female and male groups, and no correlation between AI₇₅ and ABI (P>0.05). Multivariate gradual regression analysis demonstrated that the independent positive correlation factors of AI₇₅ included female, age, waist hip ratio, central aortic systolic pressure, and the negative correlation factors were body mass index, height, fasting serum glucose (R²=0.372). Conclusion: The lack of correlation of radial augmentation index with indices for evaluating arteriosclerosis suggests that AI is not a sensitive and reliable index for evaluating the degree of arterial stiffness.

Key words: Radial artery, Vascular diseases, Atherosclerosis, Augmentation index

刘严，齐丽彤，马为，杨颖，孟磊，张宝娓，霍勇. 桡动脉反射波增强指数与其他动脉硬化指标的关系[J]. 北京大学学报（医学版）, 2013, 45(6): 916-922.

LIU Yan, QI Li-tong, MA Wei, YANG Ying, MENG Lei, ZHANG Bao-wei, HUO Yong. Relationship between radial augmentation index and other indices for evaluating arteriosclerosis[J]. Journal of Peking University(Health Sciences), 2013, 45(6): 916-922.

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