不同水平的低密度脂蛋白胆固醇人群踝肱脉搏波传导速度的研究

目的研究不同水平低密度脂蛋白胆固醇（LDL-C）与踝肱脉搏波传导速度（baPWV）的关系,探讨影响动脉弹性的主要因素。方法从哈尔滨医科大学附属第二医院体检中心2010年4月—2011年10月的体检人群中随机抽取1 075例（男728例）作为研究对象。按照血清LDL-C水平分为4组：LDL-C正常组（C组,LDL-C〈3.42 mmol/L）;LDL-C临界升高组（H1组,LDL-C 3.42mmol/L～4.20mmol/L）;LDL-C升高组（H2组,LDL-C：4.21mmol/L～4.97mmol/L）;LDL-C显著升高组（H3组,LDL-C≥4.98mmol/L）。测定各组体检者的baPWV和踝肱指数（ABI）,及其他临床指标,并行组间比较分析。结果高LDL-C组baPWV值显著高于LDL-C正常组（1 391.74cm/s±224.74cm/s比1 310.49cm/s±222.10cm/s,P=0.027）。C组和H1组baPWV值处于正常范围,且H1组baPWV值（1 351.77cm/s±229.88cm/s）明显高于C组（1 310.49cm/s±222.02cm/s）,差异有统计学意义（P=0.012）,H2组baPWV值和H3组baPWV值轻度升高,与C组、Hl组差异有统计学意义（P=0.00）。各组间ABI值差异无统计学意义（P=0.221）。baPWV逐步线性回归分析显示,收缩压（SBP）、年龄、LDL-C、高密度脂蛋白胆固醇（HDL-C）、尿酸（UA）均是影响baPWV的独立危险因素。且在控制SBP、年龄、HDL-C、UA影响因素后,LDL-C仍然与baPWV存在相关性（r=0.078,P=0.012）。结论随着LDL-C的升高,baPWV值增高,LDL-C升高者早期动脉血管弹性下降,baPWV检测有助于发现LDL-C升高的早期动脉粥样硬化。

The Researchon Brachial-ankle Pulse Wave Velocity with Different Level of Low Density Lipoprotein Cholesterol

Objective To study the relationship between the level of low density lipoprotein cholesterol（LDL-C） and branch-ankle pulse wave velocity.Methods A group of 1 075 subjects were selected and were classified into four groups：Normal LDL-C group（C group,LDL-C3.41 mmol/L）;supercritical LDL-C group（H1 group,LDL-C：3.42 to 4.20 mmol/L）,high LDL-C group（H2 group,LDL-C：4.21 to 4.97 mmol/L）;Severe high LDL-C group（H3 group,LDL-C≥4.98 mmol/L） based on the National Cholesterol Education Program Ⅲ criteria.The PWV values were tested and analyzed.Results The subjects with higher level of low-density lipoprotein cholesterol had significantly higher baPWV values （1 391.74±224.74） cm/s VS（1 310.49±222.02 cm/s,P=0.027）] than that in normal LDL-C subjects.The baPWV values in C and H1 groups whose PWV values were within normal range and the baPWV in H1 group（1 351.77±229.88） cm/s was higher than that in C group（1 310.49±222.02）cm/s with significant differences（P=0.012）.The baPWV values in H2（1 452.10±271.59） and H3 groups（1 514.10±168.87） cm/s were mildly elevated.ABI in all groups was normal with no significant differences（P=0.221）.Linear stepwise regression analysis between baPWV and other clinical subjects showed that systolic blood pressure（SBP）,age,LDL-C,uric acid（UA）,and high-density lipoprotein cholesterol（HDL-C） were associated independently with baPWV.There was a significant relationship between baPWV and LDL-C after additional adjustment of SBP,age,HDL-C,and UA.Conclusion Arterial stiffness baPWV of higher level LDL-C was significantly higher compared with that of normal level people.Early increased LDL-C might lead to mild reduction of artery elasticity.The baPWV might be helpful to detect early artery atherosclerosis.