不同收缩压水平对臂踝脉搏波传导速度影响的研究

目的 探讨不同收缩压（SBP）水平对臂踝脉搏波传导速度（baPWV）的影响。方法 在101 510 名参加2006－2007 年开滦集团职工健康体检者中随机分层抽取5 852 人作为研究对象进行横断面研究,采用统一问卷调查、血液生化及baPWV检查,其中符合入选标准（年龄≥40 岁、既往无缺血性脑卒中、短暂性脑缺血发作、心肌梗死者）5 440 人,将资料完整的5 222 人纳入统计分析。依据2010－2011 年度体检时SBP值将研究对象分为理想SBP组（SBP＜120 mmHg）、正常高值Ⅰ期组（120 mmHg≤SBP＜130 mmHg）、正常高值Ⅱ期组（130 mmHg≤SBP＜140 mmHg）、高血压组（SBP≥140 mmHg或＜140 mmHg但正在服用降压药物者）。利用多因素logistic 回归分析不同SBP水平对baPWV的影响。结果 （1）5 222（男性3 132,女性2 090）名研究对象平均年龄55.1 岁,平均baPWV（1 587.57±400.71）cm/s,baPWV≥1 400 cm/s 的检出率为62%;（2）4 组人群平均baPWV分别为1 322.19、1 456.27、1 544.78、1 827.77 cm/s,baPWV≥1 400 cm/s 的检出率分别为26.4%、49.3%、64.2%、88.3%;（3）多因素线性回归分析显示SBP的标准化β 值为0.40,仅次于年龄的0.48;（4）影响baPWV的多因素logistic 回归分析显示,校正年龄、性别等因素后,与理想SBP组比较,正常高值Ⅰ期、正常高值Ⅱ期和高血压组均为baPWV≥1 400 cm/s 的危险因素,OR值分别为2.70（95% CI：2.20～3.32）、4.56（95% CI：3.67～5.67）和13.51（95% CI：10.87～16.78）。结论 SBP升高是baPWV增加的独立危险因素。     

新疆维吾尔、哈萨克、汉族人群脑卒中与 踝臂指数和脉搏波速度的关联性研究

目的 了解新疆维吾尔族(维族)、哈萨克族(哈族)、汉族人群脑卒中与踝臂指数(ABI)和脉搏波速度(PWV)的关系.方法 资料来源于2007年10月至2010年3月新疆不同民族心血管疾病危险因素调查数据,对资料完整的维、汉、哈族14 618名35周岁以上样本进行脑卒中与ABI、PWV的关联分析.结果 (1)脑卒中患者共有633例,其中汉族258例(4.48%)、维族247例(5.18%)、哈族128例(3.13%).三个民族之间脑卒中的患病率差异有统计学意义(P＜0.001).(2)三个民族中维族发生脑卒中的风险最高、哈族最低(分别是汉族的1.304倍和0.794倍).(3)在脑卒中和非脑卒中患者之间比较,在调整了年龄、体重指数、收缩压、甘油三酯、总胆固醇等因素后,PWV与脑卒中的发生有关联(OR=1.001,P＜0.001).结论 在新疆地区维、哈、汉三个民族之间脑卒中的患病率存在明显不同;PWV与脑卒中的发生有关联.     

影响臂踝脉搏波传导速度的临床多因素分析

[目的]分析影响肱-踝动脉脉搏波传导速度(baPWV)的多种临床因素. [方法]随机抽取278例健康体检人员,使用日本科林全自动动脉硬化测定仪检测肱-踝动脉脉搏波传导速度(baPWV),按照所测baPWV值分成4组,<1 400 cm/s的为正常对照组(1组),1 400～1 600 cm/s为2组,1 600～1 800 cm/s为3组,>1 800 cm/s为4组,收集各组的临床相关资料并进行统计学分析. [结果]①2、3、4组与正常对照组比较,总胆固醇(TCH)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)无明显差异(P>0.05);年龄(age)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、脉压(PP)、血糖(GLU)、baPWV均比对照组明显升高(P<0.05),且随着baPWV升高,各指标也明显升高(P<0.05).②行单因素相关分析,年龄、SBP、DBP、MAP、PP、HR、GLU、LDL与baPWV呈正相关.③多元逐步回归分析,收缩压、年龄和心率与baPWV关系最为密切(P<0.001). [结论]年龄、SBP、DBP、MAP、PP、HR、GLU、LDL与baPWV呈正相关,其中SBP、年龄、HR与baPWV的关系最为密切,是影响动脉弹性的主要危险因素.     

高原地区有氧运动对脉搏波传导速度及踝臂指数的影响

目的 探讨世居于海拔在2 260米高原地区健康人群的影响因素.高原地区健康老年人长期有氧运动对脉搏波传导速度（pulse wave velocity,PWV）、踝臂指数的影响.方法 选择各30例经常参加有氧运动的高原地区（海拔≥2 260 m）健康老年人,分为运动组与非运动组,应用动脉脉搏波速度（PWV）自动测量肱动脉-踝动脉（baPWV）和踝臂指数（ABI）,分析运动前后的踝臂指数变化与PWV和踝臂指数的相关性.结果 长期坚持运动可使高原地区健康老年人运动组的体重、体重指数、收缩压、舒张压、脉压和心率均低于缺乏运动组（P〈0.05）,反映动脉硬化指数的baPWV 和 ABI差异有统计学意义（P〈0.01）;两组的年龄、性别和身高无统计学意义.结论 在高原地区参加有氧运动的健康人群较未参加有氧运动患者的PWV明显减低.因此适当的有氧运动可以降低高原地区老年人血管僵硬度,延缓动脉硬化进程,增强心脏和血管的功能.     

健康体检人群脉搏波传导速度特征及其与心血管疾病危险因素关系的分析

目的　分析健康体检人群脉搏波传导速度特征,及其与心血管疾病危险因素的相关性。方法　选择四川省人民医院13841名健康体检人员,询问疾病史,测量身高、体重、BMI、血压等,检测FPG、血脂、UA等生化指标,应用动脉硬化仪检测踝臂脉搏波传导速度(baPWV)。结果　健康体检男女性人群baPWV值均随年龄增长而逐渐升高,<60岁男性baPWV值明显高于女性。多元线性回归分析显示年龄、SBP、BMI、FPG、UA和TG水平均为baPWV的影响因素,其中年龄、SBP对baPWV的影响最大,标准化回归系数>0．42。结论　健康体检人群的baPWV值随性别、年龄呈不同的分布特征。应加强对老年人群,尤其是老年女性的baPWV监测,早期预防高危人群心血管事件的发生。     

冠脉慢血流患者的脉搏波传导速度和踝臂指数的变化及意义

目的：观察冠状动脉慢血流患者脉搏波传导速度（PWV）、踝臂指数（ABI）的变化及其相关性。方法：对经冠状动脉造影确诊的30例冠脉慢血流患者（慢血流组）和55例血管正常组者（血管正常组）进行PWV、ABI检测,分析冠脉慢血流患者的PWV、ABI变化特征,并与血管正常组比较。结果：与血管正常组比较,冠脉慢血流组PWV值升高,差异有统计学意义（P〈0.05）;ABI值降低,但差异无统计学意义（P〉0.05）。结论：PWV、ABI与冠脉慢血流病有一定相关,提示冠脉慢血流可能系冠脉早期动脉硬化的表现。     

厄贝沙坦治疗慢性心力衰竭患者对肱踝脉搏波传导速度及踝臂指数的影响分析

目的该研究探讨厄贝沙坦治疗慢性心力衰竭患者对肱踝脉搏波传导速度及踝壁指数的影响。方法该研究采用对照试验,将该院120例慢性心力衰竭患者随机分为实验组和对照组。实验组60例,采用厄贝沙坦进行治疗;对照组60例,采用常规抗心律失常进行治疗,治疗后比较其总有效率、肱踝脉搏波传导速度及踝壁指数的影响。结果实验组总有效率明显高于对照组,差异有统计学意义（P〈0.05）,肱踝脉搏波传导速度及踝壁指数与正常水平接近,组间差异有统计学意义（P〈0.05）。结论厄贝沙坦治疗心力衰竭对肱踝脉搏波传导速度及踝壁指数具有极为重要的作用,值得临床进一步推广应用。     

腰围、腰高比与肱踝脉搏波传导速度的相关性研究

目的 研究腰围和腰高比与肱踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)的关系,探索腹型肥胖对外周动脉弹性的影响.方法 选取2018年3月-2019年5月在中国医科大学附属第一医院体检中心体检的2718名体检者,采用动脉硬化测定仪检测双侧肢体的baPWV,根据baP...     

血脂水平对血压正常高值人群脉搏波传导速度的影响

目的 探讨血脂和脂蛋白比值对血压正常高值人群脉搏波传导速度的影响.方法 选择11 611名血压正常的健康体检者,分为正常血压值组(血压＜ 120/80 mmHg)和血压正常高值组(血压为120 ～ 139/80 ～ 89 mmHg).应用全自动动脉硬化仪测定人选者肱踝脉搏波传导速度(baPWV),同时测量身高、体重、FPG、TC、TG、HDL-C、LDL-C等指标,并计算HDL-C和TC/HDL-C比值、LDL-C/HDL-C比值.分析血脂和脂蛋白比值异常情况对不同血压组脉搏波传导速度的影响.结果 血压正常高值组的baPWV异常率均高于血压正常组.血压正常组中除HDL-C外,TC、TG、LDL-C、TC/HDL-C、LDL-C/HDL-C的升高均使baPWV的异常率显著增加(P＜0.001).血压正常高值组中,TC和LDL-C的升高使baPWV的异常率显著增加(P＜0.001).多元logistic回归分析显示,除年龄、BMI、FPG外,TC/HDL-C异常是血压正常组动脉僵硬度增高的独立危险因子(OR=1.732),TG异常是血压正常高值组的独立危险因素(OR=1.301).结论 在正常血压不同水平下,血脂和脂蛋白比值的异常是动脉僵硬度增高的独立危险因素.     

脉搏波速度和踝臂指数的测定在某特殊人群健康体检中的应用

随着人们生活水平的提高,心血管疾病发病率逐年升高。目前,心脑血管疾病已成为影响我国人均寿命的首要病因。动脉弹性功能的减退成为心血管疾病危险因素的重要标志。动脉弹性的改变早于结构改变,早期发现和干预亚临床期血管病变的进展是延缓和控制心血管事件的根本措施。现今健康体检已成为早期发现动脉弹性改变以及相关危险因素的有效手段,考虑到公安干警这一特殊群体是心血管疾病的高危人群,本研究旨在分析作为评估动脉硬化的指标：脉搏波速度（PWV）与踝臂指数（ABI）在公安干警健康体检中的意义。     

The effect of low glycemic index diet on body weight status and blood pressure in overweight adolescent girls: a randomized clinical trial

Although several studies have assessed the influence of the glycemic index on body weight and blood pressure among adults, limited evidence exists for the pediatric age population. In the current study, we compared the effects of low glycemic index (LGI) diet to the healthy nutritional recommendation (HNR)-based diet on obesity and blood pressure among adolescent girls in pubertal ages. This 10-week parallel randomized clinical trial comprised of 50 overweight or obese and sexually mature girls less than 18 years of age years, who were randomly assigned to LGI or HNR-based diet. Macronutrient distribution was equivalently prescribed in both groups. Blood pressure, weight and waist circumference were measured at baseline and after intervention. Of the 50 participants, 41 subjects (include 82%) completed the study. The GI of the diet in the LGI group was 42.67 ± 0.067. A within-group analysis illustrated that in comparison to the baseline values, the body weight and body mass index (not waist circumference and blood pressure) decreased significantly after the intervention in both groups (P = 0.0001). The percent changes of the body weight status, waist circumference and blood pressure were compared between the two groups and the findings did not show any difference between the LGI diet consumers and those in the HNR group. In comparison to the HNR, LGI diet could not change the weight and blood pressure following a 10-week intervention. Further longitudinal studies with a long-term follow up should be conducted in this regard.     

Effects of calcium and vitamin D supplementation on blood pressure and serum lipids and carotenoids: a randomized,double-blind,placebo-controlled,clinical trial

PurposeTo estimate the effects of calcium or vitamin D supplementation or a combination of both on blood pressure and serum lipid and carotenoid levels.MethodsNinety-two colorectal adenoma patients were randomized in a pilot, double-blind, placebo-controlled clinical trial of supplemental vitamin D₃ 800 IU and elemental calcium 2.0 g (as calcium carbonate) alone or in combination in divided doses twice daily with meals over 6 months.ResultsRelative to placebo, mean serum triglycerides decreased 30% (P = .10) and 32% (P = .10) in the calcium and calcium plus vitamin D₃ treatment groups, respectively. When the two calcium intervention groups were pooled and compared with the pooled noncalcium groups, the estimated supplemental calcium treatment effects were statistically significant for triglycerides (P = .04). Similar but nonstatistically significant decreases (5%–7%) were observed for serum total cholesterol levels. Mean systolic blood pressure increased 6% (P = .08) in the calcium group; otherwise, there were no appreciable changes in systolic or diastolic blood pressures in any active treatment group. Mean serum total carotenoid levels decreased 14% (P = .07) in the calcium and 9% (P = .10) in the calcium plus vitamin D₃ groups.ConclusionsOur results suggest that supplemental calcium alone or combined with vitamin D₃ but not vitamin D₃ alone may reduce serum lipids and lipophilic micronutrients.     

Folic acid and vitamin B12 supplementation lowers plasma homocysteine but has no effect on serum bone turnover markers in elderly women: a randomized,double-blind,placebo-controlled trial

An elevated homocysteine level is a newly recognized risk factor for osteoporosis. Older individuals may have elevated homocysteine levels due to inadequate folate intake and/or lower absorption of vitamin B₁₂. The aim of this study was to determine whether there is an impact of folic acid and vitamin B₁₂ supplementation on homocysteine levels and, subsequently, on bone turnover markers in older women with mildly to moderately elevated homocysteine levels. It is hypothesized that supplementation with folic acid and vitamin B₁₂ will improve homocysteine levels and, in turn, positively modify bone turnover markers in this population. This randomized, double-blind, placebo-controlled trial included 31 women (65 to 93 years) with homocysteine levels greater than 10 μmol/L. Participants were randomly assigned to receive either a daily folic acid (800 μg) and vitamin B₁₂ (1000 μg) (n = 17) or a matching placebo (n = 14) for 4 months. The results showed significantly lower homocysteine concentrations in the vitamin group compared to the placebo group (10.6 vs 18.5 μmol/L, P = .007). No significant difference in serum alkaline phosphatase or C-terminal cross-linking telopeptide of type I collagen was found between the vitamin and placebo groups before or after supplementation. The use of folic acid and vitamin B₁₂ as a dietary supplement to improve homocysteine levels could be beneficial for older women, but additional research must be conducted in a larger population and for a longer period to determine if there is an impact of supplementation on bone turnover markers or other indicators of bone health.