摘要：
目的 对比中青年血压正常者不同臂踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)的血脂水平并探讨影响baPWV的相关因素.方法 对2014年1月至2017年12月于东营市人民医院体检的1 268例中青年血压正常者的临床资料进行回顾性分析.以baPWV＜1 400cm/s作为正常动脉僵硬度的标准,分为正常动脉僵硬度组(正常组,n=1 128)、异常动脉僵硬度组(异常组,baPWV≥1 400 cm/s,n=140).统计比较分析两组血脂各指标情况,多因素分析采用Logistic回归分析,直线相关分析采用Pearson相关分析.结果 与正常组比较,异常组的总胆固醇[(4.99± 1.10) mmol/L与(4.48±1.03)mmol/L,t=5.830]、甘油三酯[(1.62±0.27) mmol/L与(1.49±0.23) mmol/L,t=5.102]、低密度脂蛋白胆固醇[(3.25±0.23) mmol/L与(3.11±0.16)mmol/L,t=4.712,t=4.836]、载脂蛋白B[(0.96±0.07) g/L与(0.87±0.08)g/L,t=4.297]均升高,高密度脂蛋白胆固醇[(1.15±0.09) mmol/L与(1.27±0.07)mmol/L,t=4.712]降低,差异均有统计学意义(P均＜0.05).影响baPWV异常的因素包括吸烟、高空腹血糖、高低密度脂蛋白胆固醇、高载脂蛋白B及低高密度脂蛋白胆固醇(P均＜0.05).异常组的总胆固醇、甘油三酯、低密度脂蛋白胆固醇、载脂蛋白B与baPWV存在正相关关系(r=0.113、r=0.120、r=0.146、r=0.143,P均＜0.05),而高密度脂蛋白胆固醇与baPWV存在负相关关系(r=-0.135,P＜0.05).低密度脂蛋白胆固醇、载脂蛋白B与baPWV呈线性回归关系(β=0.331、β=0.246,P均＜0.05).结论 低密度脂蛋白胆固醇、载脂蛋白B的升高与血压正常中青年低风险群体发生早期动脉病变的关系密切,其血脂指标虽处于正常水平范围内但这种危险性也已经存在.%Objective To compare the blood lipid levels of different brachial-ankle pulse wave velocity (baPWV) in young and middle-aged people with normal blood pressure and to explore the related factors affecting baPWV.Methods From January 2014 to December 2017,the clinical data of one thousand two hundred and sixty-eight middle-aged and young people with normal blood pressure who underwent physical examination in Dongying People's Hospital were retrospectively analyzed.Using baPWV＜ 1 400 cm/s as the standard of normal arterial stiffness,the patients were divided into normal arterial stiffness group (normal group,1 128 cases),abnormal arterial stiffness group (abnormal group,baPWV ≥ 1 400 cm/s,140 cases).The blood lipid indexes of the two groups were analyzed and compared.Logistic regression analysis was used for multivariate analysis and linear correlation analysis was used for linear correlation analysis.Pearson correlation analysis was used.Results Compared with the normal group,TC ((4.99 ± 1.10) mmol/L vs.(4.48 ± 1.03) mmoL/L,t =5.830),TG ((1.62 ± 0.27) mmol/L vs.(1.49 ± 0.23) mmol/L,t=5.102),LDL-C[(3.25±0.23) mmol/L vs.(3.11±0.16) mmol/L,t =4.712),Apo B((0.96 ±0.07) g/L vs.(0.87±0.08) g/L,t =4.297)in abnormal group all increased,and HDL-C((1.15±0.09) mmol/L vs.(1.27±0.07) mmol/L,t =4.712) decreased,and the differences were statistically significant (P＜0.05).Smoking,high FPG,high LDL-C,high Apo B,low HDL-C were the independent factors affecting baPWV abnormality (P＜ 0.05).TC,TG,LDL-C,Apo B and baPWV in abnormal group were positively correlated(P＜0.05),and HDL-C and baPWV were negatively correlated(P＜0.05).There was a linear regression relationship between LDL-C,Apo B and baPWV (P＜0.05).Conclusion The increase of LDL-C and Apo B are closely related to early arterial disease in the low-risk populations of normotensive young and middle-aged people,even the risk of blood lipid may already exist within the normal range.
