【摘要】 目的:在了解云南农村自然人群冠状动脉钙化及冠状动脉钙化积分(CACS)的分布情况的基础上,进一步探讨冠状动脉钙化及CACS与脉压差的关系。方法:对云南农村自然人群进行随机分层整群抽样,采用16排螺旋计算机断层摄影术(CT)对212名受试者进行冠状动脉扫描,评估冠状动脉钙化程度,并应用Agatston积分法计算冠状动脉钙化积分,按性别、年龄、钙化积分等分组,比较各组间脉压差,探讨冠状动脉钙化及CACS与脉压差相关性。结果:51~60岁组的平均脉压差为(44.67±13.87)mmHg(1 mmHg=0.133 kPa),61~71岁年龄组平均脉压差为(50.00±17.44)mmHg,差异有统计学意义(P=0.015),且发现脉压差与年龄呈正相关(rs=0.202,P=0.003)。按CACS分组,CACS≥100组的平均脉压差[(55.22±18.79)mmHg]大于CACS<1组[(46.87±15.46)mmHg]和1≤CACS<100组[(45.20±15.89)mmHg],差异有统计学意义(P<0.05)。CACS≥100组的脉压差增大的患者比例(47.1%)同样大于CACS<1组(17.3%)和1≤CACS<100组(15.2%),差异有统计学意义(P<0.05)。在冠状动脉钙化阳性受试者中采用Spearman秩相关分析脉压差与CACS的相关性,结果显示脉压差与CACS呈正相关(相关系数rs=0.282),相关性有统计学意义(P=0.047),且在考虑年龄、胆固醇等混杂因素后仍存在正相关关系(回归系数β=0.887)。结论:云南省农村自然人群的冠心病危险因素脉压差与CACS有关,在冠状动脉钙化者中CACS随脉压差的增大而增大。更多还原

【Abstract】 Objective: Based on coronary artery calcification(CAC) distribution in the rural population of Yunnan province, we further explored the relationship between coronary artery calcification score(CACS) and the pulse pressure difference(PPD). Methods: A randomly stratified cluster sampling method was used to study the rural population of Yunnan province and 16-MDCT scan was performed in 212 subjects for evaluating their CAC and calculating CACS. The subjects were divided into 2 sets of groups according to the age and CACS value. Age(51-60) years group, n=108 and Age(61-71) years group, n=104; CACS<1 group, n=162, 1≤CACS<100 group, n=33 and CACS≥100 group, n=17. The PPD level and the relationship between CACS and PPD were compared among different groups.Results: The average PPD level in Age(61-71) years group was(44.67±13.87) mmHg and in Age(61-71) yearsgroup was(50.00±17.44) mmHg, P=0.015, PPD was positively related to age, rs=0.202, P=0.003. The average PPD level in CACS≥100 group, CACS<1 group and 1≤CACS<100 group were(55.22±18.79) mmHg,(46.87±15.46) mmHg and(45.20±15.89) mmHg respectively, P<0.05. The patients with increased PPD level in CACS≥100 group was 47.1%, in CACS<1 group was 17.3% and in 1≤CACS<100 group was 15.2%, P<0.05. Spearman rank correlation analysis indicated that PPD level was positively related to CACS, rs=0.282, P=0.047, with adjusted confounding factors such as age and blood cholesterol level, the PPD was still positively related to CACS.Conclusion: PPD as a risk factor of coronary artery disease is related to CACS in rural population of Yunnan province, the CACS increased accordingly with the elevated PPD level.更多还原