中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2011, Vol. 33 ›› Issue (2): 162-168.doi: 10.3881/j.issn.1000-503X.2011.02.013

• 论著 • 上一篇    下一篇

高龄高血压患者外周动脉性疾病患病率及危险因素

丁一妹1,王 玉1 ,李 燕1 ,杨 培2 ,刘敏艳3 ,刘 亮4 ,朱 平1 ,李小鹰1   

  1. 1解放军总医院南楼心血管一科,北京 100853  2首都医科大学 附属北京安贞医院血管外科,北京100029  3解放军总医院老年内分泌科,北京 100853  4解放军总医院医疗处,北京 100853
  • 收稿日期:2010-09-08 出版日期:2011-04-10 发布日期:2011-04-10
  • 通讯作者: 李小鹰 电话:010-66876221 E-mail:lixy@mx.cei.gov.cn
  • 基金资助:

    国家十一五新药研发技术平台资助课题(2008ZX09312-006-02)

Prevalence and Risk Factors of Peripheral Arterial Diseases in Male Chinese Octogenarians and Nonagenarians with Hypertension

DING Yi-mei1,WANG Yu1 ,LI Yan1 ,YANG Pei2 ,LIU Min-yan3 ,LIU Liang4 ,ZHU Ping1 ,LI Xiao-ying1   

  1. 1Department 1 of Nanlou Cardiology, PLA General Hospital, Beijing 100853, China 2 Department of Vascular Surgery, Capital Medical University Affiliated Beijing Anzhen Hospital, Beijing 100029, China 3Department of Geriatric Endocrinology, PLA General Hospital, Beijing 100853, China 4 Devision of Medical Service, PLA General Hospital, Beijing 100853, China
  • Received:2010-09-08 Online:2011-04-10 Published:2011-04-10
  • Contact: LI Xiao-ying Tel: 010-66876221 E-mail:lixy@mx.cei.gov.cn

摘要: 目的 了解高龄高血压患者外周动脉性疾病(PAD)患病率及其危险因素。方法 无损伤周围血管检查仪测定门诊及住院老年男性高血压患者踝肱指数(ABI)、标准问卷调查及各项指标测量确定患者身体基线状况;任一侧肢体ABI≤0.9诊断为PAD。结果 290例坚持服用降压药物的高龄男性高血压患者,9例除年龄、ABI外部分基线资料不全,平均年龄(84.61±4.20)岁,平均ABI值0.948±0.258,ABI分布频率最高的区间为0.91~1.30,其中106例为PAD患者,182例为非PAD患者,2例ABI>1.3。PAD患者的ABI值明显低于非PAD患者(P0.05)。采用多因素Logistic 回归分析显示,年龄(OR值1.12,95%置信区间1.014-1.238)、尿素氮(OR值1.15,95%置信区间1.025-1.301)、天冬氨酸氨基转移酶(OR值1.05,95%置信区间1.005-1.089)、糖尿病(OR值4.02,95%置信区间1.797-9.009)、冠心病(OR值6.34,95%置信区间1.734-23.214)是PAD的独立危险因素(P<0.05)。结论 高龄高血压患者PAD患病率高,PAD的发生与年龄、尿素氮、天冬氨酸氨基转移酶、糖尿病、冠心病明显相关。

关键词: 高血压, 外周动脉疾病, 踝肱指数, 危险因素

Abstract: Objective To investigate the prevalence and risk factors of peripheral arterial disease (PAD) in male Chinese octogenarians and nonagenarians with hypertension. Methods Ankle-brachial index (ABI) was measured in the noninvasive vascular laboratory for hypertensive male octogenarians and nonagenarians enrolled from outpatient and inpatient departments. The baseline conditions were investigated using standard questionnaire and by routine physical examinations. PAD was diagnosed when an ABI≤0.9 in either lower extremity. Results Totally 290 male Chinese octogenarians and nonagenarians [age: (84.61±4.20) years] with hypertension who were receiving antihypertensive therapy were enrolled in this study, among whom 9 men with missing data except age and ABI measurements. The ABI was 0.948±0.258, with the range of highest frequency of 0.91-1.30, and 106 patients were diagnozed as PAD, 182 as non-PAD, and 2 had ABI>1.3. ABI in hypertensive men with PAD were significantly lower than in those without PAD (P<0.05). On the contrary, age, blood urea nitrogen, white blood cell counts, platelets and aspartic transaminase were significantly higher in PAD patients than in non-PAD patients (all P<0.05). The prevalence of PAD in this study population were 36.5%; more specifically, it significantly differed between different subgroups when stratified by age (28.6% vs. 46.3%, below and above 85 years), with and without hypertension (27.5% vs. 40.1%), stroke (44.7% vs. 27.5%), dyslipidemia (41.4% vs. 33.3%), coronary artery disease (44.1% vs. 13.9%), and diabetes mellitus (53.7% vs. 21.8%) (all P<0.05). The prevalences of PAD in hypertensive patients treated with diuretics, calcium antagonists, beta-blocker, or angiotensin receptor antagonist were 41.4%, 36.1%, 22.4%, and 26.8%, respectively. No association was observed between the prevalence of PAD and smoking/alcohol drinking in these subjects. Multivariate analysis showed that age (OR 1.12, 95%CI 1.014-1.238), blood urea nitrogen (OR 1.15, 95%CI 1.025-1.301), aspartic transaminase (OR 1.05, 95%CI 1.005-1.089), diabetes mellitus (OR 4.02, 95%CI 1.797-9.009), coronary artery disease (OR 6.34, 95%CI 1.734-23.214) were strong risk factors of PAD. Conclusion PAD is highly prevalent among aged Chinese hypertensive men, in which age, blood urea nitrogen, aspartic transaminase, diabetes mellitus, coronary artery disease may be involved in the development of this condition.

Key words: hypertension, peripheral arterial disease, ankle brachial index, risk factors

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