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[高血压患者靶器官损害与踝臂指数异常的关联]

[The association of target organ damage with abnormal ankle brachial index in hypertensive patients].

作者信息

Mao Yong, Yu Jin-ming, Zhang Fen, Zhan Yi-qiang, Hu Da-yi, Jiang Qing-wu

机构信息

School of Public Health, Fudan University, Shanghai, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2012 Feb;51(2):127-30.

Abstract

OBJECTIVE

To investigate the association of hypertensive target organ damage with abnormal ankle brachial index (ABI) in high-risk hypertensive patients.

METHODS

During December 2008 to May 2009, a cross-sectional study was conducted to investigated the prevalence of abnormal ABI (ABI < 0.90) in 2674 community-dwelling, hypertensive patients, who aged > 40 years, without coronary heart disease, stroke/transient ischemic attack or known arteriosclerosis, from 18 centers in China. Data were acquired through history, physical examination, laboratory and other diagnostic tests.

RESULTS

There were 2615 subjects eligible for the full analysis set. The high-risk hypertensive patients with arterial wall thickening, arterial wall thickening and slightly elevated serum creatinine had a higher prevalence of abnormal ABI than their counterparts respectively (P < 0.05). Compared with the normal group, the abnormal ABI group had a higher serum creatinine level on average (P < 0.01). After adjustment for certain factors including investigation center, demographic factors, cardiovascular disease (CVD) risk and CVD risk factors using an unconditional logistic regression model, arterial wall thickening (OR 2.416, 95%CI 1.395 - 4.183, P = 0.0016) and slightly elevated serum creatinine (OR 3.377, 95%CI 1.267 - 8.997, P = 0.0149) were positively associated with abnormal ABI. However, arterial wall thickening (OR 0.988, 95%CI 0.576 - 1.695, P = 0.9664) and microalbuminuria (OR 1.389, 95%CI 0.685 - 2.817, P = 0.3621) were irrelevant to abnormal ABI.

CONCLUSIONS

So far as a high-risk hypertensive patient is concerned, there are significant statistical correlations between arterial wall thickening and/or slightly elevated serum creatinine and an abnormal ABI, but no significant statistical correlations between arterial wall thickening or microalbuminuria and an abnormal ABI is observed.

摘要

目的

探讨高危高血压患者高血压靶器官损害与踝臂指数(ABI)异常之间的关联。

方法

2008年12月至2009年5月,开展一项横断面研究,调查来自中国18个中心的2674名年龄>40岁、无冠心病、中风/短暂性脑缺血发作或已知动脉硬化的社区高血压患者中ABI异常(ABI<0.90)的患病率。通过病史、体格检查、实验室检查及其他诊断性检查获取数据。

结果

有2615名受试者符合完整分析集标准。动脉壁增厚、动脉壁增厚且血清肌酐轻度升高的高危高血压患者ABI异常的患病率分别高于相应对照组(P<0.05)。与正常组相比,ABI异常组平均血清肌酐水平更高(P<0.01)。使用无条件逻辑回归模型对调查中心、人口统计学因素、心血管疾病(CVD)风险及CVD危险因素等某些因素进行校正后,动脉壁增厚(比值比2.416,95%可信区间1.395 - 4.183,P = 0.0016)和血清肌酐轻度升高(比值比3.377,95%可信区间1.267 - 8.997,P = 0.0149)与ABI异常呈正相关。然而,动脉壁增厚(比值比0.988,95%可信区间0.576 - 1.695,P = 0.9664)和微量白蛋白尿(比值比1.389,95%可信区间0.685 - 2.817,P = 0.3621)与ABI异常无关。

结论

就高危高血压患者而言,动脉壁增厚和/或血清肌酐轻度升高与ABI异常之间存在显著统计学相关性,但未观察到动脉壁增厚或微量白蛋白尿与ABI异常之间存在显著统计学相关性。

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