社区动脉硬化早期检测适宜技术应用研究

目的探讨社区人群脉搏波速度(PWV)与心血管疾病危险因素之间的关系及在社区开展动脉硬化早期检测适宜技术的意义。方法选取2009年10月—2010年2月在什刹海社区卫生服务中心就诊的患者,取其资料完整者400例作为本研究对象。按是否患有高血压、糖尿病、脑卒中、冠心病、高脂血症分为慢性病组和对照组,进行流行病学调查,收集相关临床资料并检测相关生化指标。应用日本科林公司的全自动动脉硬化检测仪VP-1000检测研究对象的肱-踝脉搏波速度(baPWV)和踝臂指数(ABI)。采用SAS 6.2统计软件进行数据分析和处理。结果慢性病组的baPWV值显著高于对照组,差异有统计学意义(P<0.01)。Logistic回归分析显示,收缩压和baPWV是慢性病的独立危险因素(P<0.01);年龄和空腹血糖是影响baPWV的独立因子(P<0.01),尤其是45岁以上人群baPWV值显著升高。对照组中有28.05%的人baPWV值异常。结论 baPWV是慢性病的独立预测因子,baPWV与年龄、空腹血糖相关;baPWV测定可作为早期诊断动脉硬化的首选和常规检查手段,适合在社区推广。

Application of Early Detecting Technique for Arteriosclerosis in Community

Objective To investigate the relationship between pulse wave velocity(PWV) and the risk factors of cardiovascular disease(CVD) among community population,and to assess the significance of developing an early detecting technique for arterial stiffness in community.Methods 400 patients who visited Shichahai community health service center from Oct 2009 to Feb 2010 with complete medical records were selected as the study subjects.Patients were divided into the control group and the chronic diseases group(suffering from hypertension,type 2 diabetes mellitus,stroke,coronary heart disease or hyperlipidemia).Clinical data were collected and related biochemical indicators were measured.The VP-1000 automatic arterial stiffness determinator was used for measuring the left and right braehial-ankle PWV(baPWV) and the ankle-brachial index(ABI).SAS 6.2 software was used to analyze and process the data.Results The baPWV of the chronic diseases group was significantly higher than that of the control group(P<0.01).Logistic regression analysis showed that both systolic blood pressure and baPWV were independent risk factors of chronic diseases(P<0.01).Age and fasting blood glucose are independent factors affecting baPWV(P<0.01),especially in patients of over 45 years old.The prevalence of abnormal baPWV in the control group was 28.05%.Conclusion The baPWV,which is related to age and fasting blood glucose,is an independent risk predictor of cardiovascular diseases.The baPWV is the first choice for the early detection of arterial stiffness and routine examination technique for in community popularization.