心踝血管指数对高血压及合并糖尿病患者血管功能的评价

CAVI in the evaluation of vascular function in patients with hypertension and type 2 diabetes mellitus

关键词:  原发性高血压  2型糖尿病  心踝指数  年龄

Key words:  [Key words]　essential hypertension  type 2 diabetic mellitus  cardio-angle vascular index  age

摘要:

[摘要]　目的　探讨在高血压及高血压合并糖尿病人群中心踝指数（CAVI）与心血管危险因素的相关性。　方法　连续入选原发性高血压患者82例（EH组）及高血压合并糖尿病患者35例（EH+T2DM组），记录性别、年龄、身高、体重、血压、脉压等背景资料。记录心电图，测定CAVI，使用心脏超声仪测定心脏结构，根据Devereux公式计算左室重量指数(LVMI)。并根据Ccockcroft-Gault公式计算肌酐清除率（Ccr）。通过回归分析分析CAVI与各心血管危险因素的相关性。　结果　EH+T2DM组、双侧CAVI均明显高于EH组，左右CAVI分别为（8.20±1.26） vs.（7.50±1.20）, P=0.005；（8.17±1.29） vs. （7.50±1.22），P=0.009。CAVI与年龄、收缩压、脉压呈正相关(P=0.000，0.028,0.000；r=0.568,0.200,0.328)，与肌酐清除率呈负相关（P=0.000, r=-0.444）。年龄、收缩压与CAVI独立相关（P=0.000,0.008；r=0.603,0.464）。　结论　CAVI可以作为一种便捷的动脉硬化评价指标,但不同的年龄组应设定不同的正常值。

Abstract:

[Abstract]　Objective　To evaluate the relationship between cardiovascular risk factors and cardio-ankle vascular index (CAVI) in hypertensive and diabetic population.　Methods　82 essential hypertensive patients (EH) and 35 hypertensive patients with type 2 diabetic mellitus (EH+T2DM) were enrolled. Clinicaldata, including gender, age, height, body weight, blood pressure, and pulse pressure were collected. ECG and ecocardiography were taken. Urine aliquot and venous blood were collected. Urinary albumin, urine creatinine, serum creatinine were tested. Urinary albumin/creatinine ration (ACR) was calculated. Left ventricular mass index and creatinine clearance were calculated by Devereux fomular and Ccockcroft-Gault formular, respectively. Correlation analysis between CAVI and cardiovascular risk factor were run by SPSS 19.0.　Results　Bilateral CAVI were significantly higher in EH+T2DM group compared to EH group；8.20±1.26 vs. 7.50±1.20, P=0.005；8.17±1.29 vs. 7.50±1.22，P=0.009, respectively). CAVI was positively correlated with age,SBP, and PP (P= 0.000, 0.028, 0.000, respectively; r=0.568, 0.200, 0.328, respectively). CAVI was negatively correlated with eGFR (P=0.000, r=-0.444). Age and SBP were independently correlated with CAVI (P=0.000, 0.008；r=0.603,0.464, respectively).　Conclusion　CAVI could be used as a convenient way to evaluate arteriosclerosis, but different age group should be set corresponding normal CAVI value.