慢性舒张性心力衰竭患者动脉僵硬度影响因素分析

摘要

目的探讨慢性舒张性心力衰竭患者动脉僵硬度的影响因素.方法选取慢性舒张性心力衰竭患者354例,测量身高、体重、血压,计算BMI,采集空腹静脉血分析血脂、血糖、血浆B型脑钠肽(BNP)等指标,超声心动图检查各项指标,采用动脉硬化检测仪测量CAVI,分析CAVI与各临床特征的相关性.结果单因素相关分析结果显示,CAVI与年龄、收缩压、BNP呈明显正相关(r=0.3664、0.1193、0.2591,P<0.05或0.01),与BMI、E/A呈显著负相关(r=0.2040、0.1759,均P<0.01)；多元逐步回归分析显示,高龄、女性、吸烟史、BMI、BNP、E/A是CAVI的独立影响因素(β=0.0443、0.2617、-0.0675、0.3904、0.4939、-0.7899,P<0.05或0.01),且E/A比值作用最强(P<0.05).结论老龄、女性、吸烟、BMI、BNP、E/A是影响慢性舒张性心力衰竭患者动脉僵硬度的主要危险因素.%Objective To investigate the factors affecting arterial stiffness in patients with chronic diastolic heart failure. Methods Three hundred and fifty four patients with chronic diastolic heart failure were enrol ed in the study. The height, weight, blood pressure was measured, and body mass index calculated. Fasting blood lipids, blood glucose, plasma B-type natriuretic peptide (BNP) and other indicators were measured. Echocardiography and Cardio-Ankle Vascular Index (CAVI) was evaluated. The correlation of CAVI and other clinical parameters was analyzed. Results The univariance analysis showed that CAVI was positively correlated with age (r=0.3664, P<0.01), systolic blood pressure (r=0.1193, P<0.05), and BNP (r=0.2591, P<0.01), and negatively correlated with body mass index (r=-0.2040, P<0.01) and E/A ratio (r=-0.1759, P<0.01). Stepwise multiple re-gression analysis showed that age, sex, smoking history, body mass index, BNP and E/A ratio were the independent risk factors of CAVI (β=0.0443, 0.2617,-0.0675, 0.3904, 0.4939,-0.7899;P<0.05 or 0.01), and the E/A ratio was the strongest influencing factor (P<0.05). Conclusion Aging, female sex, smoking, and body mass index, BNP and E/A ratio are the major risk factors of arterial stiffness in patients with chronic diastolic ventricular failure.