健康体检人群脉搏波传导速度的影响因素分析

摘要

目的：了解健康体检人群肱踝脉搏波传导速度（baPWV）的影响因素。方法选取2011年3月~2012年3在武警总医院健康医学中心体检的1579例体检者，检测其血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、空腹血糖（FBG），同时测定体质指数（BMI）、收缩压（SBP）、收缩压（DBP）。采用动脉硬化测定仪测定双侧肢体的baPWV，并以baPWV≥14 m/s为动脉僵硬度增高。采用多因素Logistic回归分析确定影响动脉弹性的危险因素，采用ROC曲线判断相关影响因素对baPWV的预测价值。结果 BMI、TG、TC、LDL-C、SBP、DBP、FBG、年龄在baPWV正常组及升高组有显著差别（P均＜0.01）；多因素Logistic分析显示，年龄、SBP、TG、BMI为baPWV的独立影响因素（P均＜0.01）；通过ROC曲线分析，AUC曲线下面积最高的为SBP，为0.81，SBP切点选择在135mmHg时，敏感性为64%，特异性为81%。结论年龄、SBP、TG、BMI为baPWV的独立影响因素；收缩压对baPWV最有预测价值。%Objective To analyze the influencing factors of brachial-ankle pulse wave velocity (baPWV) in healthy check-up receivers.Methods The healthy check-up receivers (n=1579) were chosen from Mar. 2011 to Mar. 2012, and their levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), fasting plasma glucose (FPG), body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were detected. The level of bilateral limb baPWV was detected by using atherosclerosis tester and baPWV≥14 m/s was defined as elevated arterial stiffness. The influencing factors of arterial elasticity were determined by applying multiple Logistic regression analysis, and predictive value of related influencing factors to baPWV was estimated by using ROC curve.Results There was significant difference in BMI, TG, TC, LDL-C, SBP, DBP, FPG and age between normal group and elevating group (allP<0.01). The multiple Logistic regression analysis showed that age, SBP, TG and BMI were independent influencing factors of baPWV (allP<0.01). ROC curve analysis showed that the area under AUC curve of SBP was the largest (0.81), and SBP sensitivity was 64% and its specificity was 81% when cut-off point of SBP was selected at 135 mmHg.Conclusion Age, SBP, TG and BMI are independent influencing factors of baPWV, and SBP is the most important predictive factor.