臂踝脉搏波传导速度在缺血性脑卒中高危风险人群早期筛查中的应用
焦作市第二人民医院，河南 焦作 454000
基金项目：2020 年度河南省医学科技攻关计划联合共建项目（编号：LHGJ20200827）；2018 年度河南省医学科技攻关计划联合共建项目（编号：2018020998）；焦作市2019 年科技计划项目（编号：20194816813）
作者简介：辛志芳，Email：xzf3285@163.com
△通信作者：李晓杰，Email：849183938@qq.com
【摘要】 目的 分析臂踝脉搏波传导速度（BaPWV）在缺血性脑卒中高危风险人群早期筛查中的临床意义及参考价值。方法 采用动脉硬化检测仪对2018-01—2020-12 在焦作市第二人民医院脑卒中筛查门诊开展对就诊人群进行脑卒中风险筛查，分析其高危风险因素。根据四分位法将测量BaPWV 的人群分成4 组，各临床指标与动脉硬化指标BaPWV 的相关性采用logistic 回归分析。结果 5 000 例筛查对象中筛查出有脑卒中高危风险者708 例；将动脉硬化检测仪所测得的BaPWV 四分位分组后，基线指标中年龄、身高、体质量、体重指数、血压、空腹血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、三酰甘油、尿酸及同型半胱氨酸指标在Q1～Q4 组间差异有统计学意义（P＜0.05）；二元多因素logistic 回归分析显示，性别、年龄、血压、同型半胱氨、尿酸酸与动脉硬化风险指标BaPWV 存在明显相关性。结论 大动脉血管壁的弹性和顺应性改变会促进动脉粥样硬化形成，增加脑卒中发病风险，采用动脉硬化检测仪定期进行脑卒中险筛查有助于早期发现动脉粥样硬化并预测脑血管功能健康状态。
【关键词】 脑卒中；臂踝脉搏波传导速度；动脉硬化；高危风险；早期筛查
【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1673-5110 （2021） 24-2176-08 DOI：10.12083/SYSJ.2021.23.009
XIN Zhifang，LI Xiaojie，CHENG Xiaochen，LI Bo，LI Jiajia，LI Sufang The Second People’s Hospital of Jiaozuo，Jiaozuo 454000，China
【Abstract】 Objective To analyze the clinical significance and reference value of brachial-ankle pulse wave velocity（BaPWV）in early screening of high risk population for ischemic stroke. Methods The stroke risk screening was carried out in the stroke screening and follow-up clinic of Jiaozuo Second People’s Hospital from January 2018 to December 2020，and the high risk factors were analyzed. According to the quartile method，the people who measured BaPWV were divided into 4 groups. The correlation between clinical indexes and arterioscle⁃ rosis index BaPWV was analyzed by logistic regression analysis. Results Among 5，000 screening population，708 people with high risk of stroke were screened. After grouping the quartile of BaPWV measured by arteriosclerosis tester，there were significant differences in age，height，body mass，body mass index，blood pressure，fasting blood glucose，glycosylated hemoglobin，total cholesterol，low density lipoprotein cholesterol，high density lipoprotein cholesterol，triglyceride，uric acid and homocysteine between Q1-Q4 groups. The results of binary multivariate logistic regression analysis showed that sex，age，blood pressure，homocysteine and uric acid were significantly correlated with arteriosclerosis risk index BaPWV. Conclusion The changes of elasticity and compliance of large arteries can increase the risk of stroke. Regular stroke risk screening with arteriosclerosis detector is helpful to detect atherosclerosis early and predict the health status of cerebrovascular function.
【Key words】 Stroke；Brachial-ankle Pulse Wave Velocity；Arteriosclerosis；High-risk risk；Early screening