脉搏波速度和踝臂指数与心血管危险因素的关系

目的：研究老年患者肱踝脉搏波速度(brachial-ankle pulse wave velocity，baPWV)和踝臂指数(ankle-brachial index, ABI)与心血管危险因素的关系，并探讨baPWV和ABI在老年患者动脉硬化评估中的临床价值。方法：191例老年患者，男123例，女68例，平均年龄（71.73±7.95）岁，采用VP-1000全自动动脉硬化测定仪分别检测患者血压、双侧baPWV和ABI。结果：老年患者中合并大动脉硬化者110例，总发病率为57.6%，与高血压病直接相关(P＜0.05),其OR值为10.569，95%可信区间CI为4.748-23.527,而且与性别、年龄密切相关(P＜0.05)；合并外周血管疾病（peripheral arterial disease，PAD）者36例，发病率为18.8%，并且合并PAD与糖尿病直接有关（P＜0.05），其OR值为4.383，95%可信区间CI为1.974-9.733（P＜0.001）。结论：baPWV和ABI是两个相互独立的无创性、敏感性指标，两者相互结合可以有效地评估老年患者心血管危险因素的危害程度。

Correlation between pulse wave velocity and ankle-brachial index and cardiovascular risk factors in elderly patients

Objective: To obtain reliable data on the epidemiology,co-morbidities and risk factor profile of large artery arteriosclerosis and peripheral arterial disease(PAD),the clinical significance of brachial-ankle pulse wave velocity(baPWV) and ankle-brachial index(ABI) were evaluated as indicators of arteriosclerosis and PAD in aged patients.Methods: One hundred and ninety-one elderly patients(64.4% male,71.73 years old in mean) were recruited for this study. baPWV and ABI were measured by the VP-1000 automatic arteriosclerosis measurement system.Results: One hundred and ten elderly patients(57.6%) were found to have large artery arteriosclerosis.The risk of large artery arteriosclerosis in elderly patients became higher with an increase of age(OR=1.060,95% CI=1.010-1.113).Gender(OR=2.494,95% CI=1.067-5.825) and history of hypertension(OR=10.569,95% CI=4.748-23.527) were independently associated with high baPWV(P<0.05).Moreover,36 elderly patients(18.8%) were found to have PAD.The risk of PAD in elderly patients was related to a history of diabetes mellitus(OR=4.383,95%CI=1.974-9.733,P<0.001).Conclusion: BaPWV and ABI measurements are sensitive and independent indicators for evaluating the degree of arteriosclerosis and occlusion in the aged,which can effectively evaluate cardiovascular risk factors in elderly patients.