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脉搏波传导速度及踝肱指数对心血管病患者的预后价值

  

  1. 河北医科大学第二医院  河北省心脑血管病研究所 心内一科,河北 石家庄 050000
  • 出版日期:2019-11-20 发布日期:2020-01-09
  • 通讯作者: 崔炜, Email:cuiwei21c@163.com

Prognostic value of pulse wave velocity and anklebrachial index

  1. First Department of Cardiology,  the Second Hospital of Hebei Medical University and Institute
    of Cardio abd cerebrovascular Disease of Hebei Province,  Shijiazhuang 050000,  China
  • Online:2019-11-20 Published:2020-01-09
  • Contact: Corresponding author: Cui Wei, Email:cuiwei21c@163.com

摘要: 目的  探索脉搏波传导速度及踝肱指数是否与心血管病患者的预后相关,在引入新的预后指标后,传统的监测指标是否还有意义。方法  纳入住院患者353例。回顾性分析患者临床资料,并在出院后进行随访。采用多因素logistic回归分析和倾向评分匹配分析血管功能指标是否为心血管病患者预后不良的独立影响因素。结果  随访中53例患者出现心血管事件,11例患者死亡。与无事件组患者比较,有事件组患者心力衰竭、应用血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂(ACEI/ARB)类药物者较多,踝肱指数较小。与存活组患者比较,全因死亡组患者踝肱指数较小。心力衰竭及ACEI/ARB类药物是影响心血管病患者预后的独立危险因素,而踝肱指数是死亡的独立影响因素。倾向评分匹配后结果表明心力衰竭及踝肱指数为心血管病患者预后的独立影响因素。在冠心病变亚组分析中,性别、心力衰竭、脑卒中、ACEI/ARB类药物是影响预后的独立危险因素,踝肱指数是心血管病患者死亡预后的独立影响因素。结论  踝肱指数是影响心血管病患者预后的独立因素;在引入血管功能监测指标后,仅踝肱指数及心力衰竭对心血管病患者预后有预测价值, 而传统的心血管病危险因素对预后无预测价值。

关键词: 心血管疾病, 预后, 脉搏波传导速度, 踝肱指数

Abstract: Objective  To investigate whether pulse wave velocity and anklebrachial index  are related to the prognosis of patients with cardiovascular disease,  and whether the traditional monitoring indexes are still meaningful after the introduction of the new prognostic index. Methods  A total of 353 patients were included. The clinical data of patients were analyzed retrospectively and they were followed up after hospital discharge. Multivariate logistic regression analysis and propensity score matching  were used to determine whether the vascular function indicators were independent influencing factors for poor prognosis of patients with cardiovascular disease. Results  During the followup, totally 53 patients had cardiovascular events, and 11 cases died. Compared with patients in nonevent group,  patients in event group had higher risk of  heart failure and were more likely to have angiotensinconverting enzyme inhibitors/angiotensin receptor antagonists(ACEI/ARB),  and the anklebrachial index was smaller. Compared with patients in the survival group, the anklebrachial index was smaller in the allcause death group. Heart failure and ACEI/ARB were independent risk factors for the prognosis of patients with cardiovascular disease,  and anklebrachial index was an independent factor for death. Heart failure and anklebrachial index were independent risk factors influencing prognosis of patients with cardiovascular disease after propensity score matching. In the coronary heart disease subgroup analysis, gender,  heart failure,  stroke,  and ACEI/ARB drugs were independent risk factors for prognosis, while the anklebrachial index  was an independent factor for the death of  patients with cardiovascular disease.Conclusion  The anklebrachial index  was an independent factor for the prognosis of patients with cardiovascular diseases. After the introducing of vascular function monitoring indicators,  only anklebrachial index  and heart failure had predictive value for the prognosis of cardiovascular patients, while traditional cardiovascular risk factors had no predictive value.

Key words: cardiovascular diseases;prognosis, pulse wave velocity, anklebrachial index