体检人群心踝血管指数与脂肪肝的相关性研究

发布时间：2018-03-23 12:23

本文选题：体检人群　切入点：心踝血管指数　出处：《重庆医科大学》2017年硕士论文

【摘要】：背景:心血管疾病(Cardiovascular diseases,CVD)目前被公认为全球范围内疾病死亡的最主要原因,在我国由于人们膳食结构的改变以及缺乏运动等原因导致心血管疾病的发病率和死亡率逐年上升。动脉粥样硬化(Atherosclerosis,AS)是一种慢性炎症性疾病,研究表明,动脉粥样硬化是冠心病、高血压等心血管疾病的危险因素,甚至对心血管疾病具有预测和诊断价值。动脉僵硬度增加是动脉粥样硬化的表现之一,是心血管疾病结局的独立预测因素。虽然脉搏波速度(pulse wave velocity,PWV)一直以来被作为评估动脉僵硬度的常用方法,但其准确性受血压变化的影响。为了消除瞬时血压变化对测量的影响,诞生了一种新的测量动脉僵硬度的指标——心踝血管指数(cardio-ankle vascular index,CAVI),由于它引入了僵硬指数β,能够排除在检测时血压波动这一影响因素,已有大量研究证实CAVI可以较好地预测早期动脉粥样硬化。脂肪肝(Fatty liver,FL)是由代谢、环境、遗传等综合因素导致的肝内脂肪蓄积过多的一种临床病理综合征。目前脂肪肝已成为全球范围内慢性肝病的最常见的原因,脂肪肝的患病率在西方达20%~40%,在中国为15%~35%,脂肪肝被认为是代谢综合征的肝脏表现。动脉粥样硬化与脂肪肝的相关性逐渐受到研究人员的重视,这方面的研究也逐渐增多,也取得了一定的共识,对于心血管疾病的防治具有一定的指导意义,但是作为评价动脉僵硬度的新指标——CAVI与脂肪肝的相关性研究尚少。目的:研究重庆市体检人群心踝血管指数(cardio-ankle vascular index,CAVI)与脂肪肝之间的相关性。方法:选取2015年1-12月在重医一院健康体检部进行健康体检的3218人。按照是否有脂肪肝,分为正常对照组(n=2298例)和脂肪肝组(n=920例),比较两组CAVI值的大小及动脉硬化检出率,并且采用回归分析评估脂肪肝的危险因素。CAVI值采用血压脉搏测量装置测量,脂肪肝采用彩色多普勒超声检测。结果:1.脂肪肝组和对照组的性别构成比有统计学差异,男性比例高于女性((P0.05)。2.脂肪肝组的CAVI值比对照组的CAVI值显著升高[(8.00±1.14)vs(7.80±1.07),P0.05]。3.脂肪肝组的动脉硬化检出率显著高于对照组,差别有统计学意义(P0.05)。4.将性别、体质量指数、收缩压、舒张压、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、三酰甘油、空腹血糖、CAVI作为自变量,是否有脂肪肝作为应变量,进行多变量Logistic回归分析,校正性别、收缩压、舒张压、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇后发现体质量指数、三酰甘油、空腹血糖、CAVI升高是脂肪肝的易患危险因素,CAVI与脂肪肝密切相关。结论:心踝血管指数与脂肪肝密切相关,体检人群中筛查发现脂肪肝者需更加重视动脉硬化的早期筛查,这样更有助于心血管疾病早期预防。
[Abstract]:Background: cardiovascular disease CVD is currently recognized as the leading cause of death from disease worldwide. The morbidity and mortality of cardiovascular diseases are increasing year by year because of the change of dietary structure and lack of exercise in China. Atherosclerosis (Atherosclysis ASA) is a chronic inflammatory disease. Studies have shown that atherosclerosis is coronary heart disease. The risk factors of cardiovascular diseases such as hypertension, even have predictive and diagnostic value for cardiovascular diseases. Increased arterial stiffness is one of the manifestations of atherosclerosis. It is an independent predictor of the outcome of cardiovascular disease. Although pulse wave velocityPWV has been used as a commonly used method for evaluating arterial stiffness, its accuracy is affected by changes in blood pressure. A new measure of arterial stiffness, cardio-ankle vascular index (CAVII), was born. Because of the introduction of stiffness index 尾, it can exclude the influence factor of blood pressure fluctuation during detection. A large number of studies have shown that CAVI is a good predictor of early atherosclerosis. Fatty liver liverFLL is metabolized by the environment. Fatty liver is the most common cause of chronic liver disease in the world. The prevalence of fatty liver is 20% in the west and 1535% in China. Fatty liver is considered to be the liver manifestation of metabolic syndrome. There is also a certain consensus, which has certain guiding significance for the prevention and treatment of cardiovascular disease. However, as a new index for evaluating arterial stiffness, there are few studies on the correlation between CAVI and fatty liver. Objective: to study the correlation between cardio-ankle vascular index (CAVII) and fatty liver. Methods: from January to December 2015, the relationship between CAVII and fatty liver was studied. 3218 people in the health examination department of a major medical hospital. According to whether they have fatty liver, Two groups were divided into normal control group (n = 2298) and fatty liver group (n = 920). The size of CAVI and the detection rate of arteriosclerosis were compared between the two groups. The risk factors of fatty liver were evaluated by regression analysis. Fatty liver was detected by color Doppler ultrasound. Results: 1. Sex composition ratio of fatty liver group and control group was significantly different. The CAVI value of fatty liver group was significantly higher than that of control group [8.00 卤1.14)vs(7.80 卤1.07% P 0.05] .3.The detection rate of arteriosclerosis in fatty liver group was significantly higher than that in control group (P 0.05), and the difference was statistically significant (P 0.05 路4.The sex, body mass index, systolic blood pressure, diastolic blood pressure) were significantly higher in fatty liver group than in control group. Low density lipoprotein cholesterol, high density lipoprotein cholesterol, triacylglycerol, fasting blood glucose CAVI as independent variable, fatty liver as dependent variable, multivariate Logistic regression analysis, sex, systolic blood pressure, diastolic blood pressure, High density lipoprotein cholesterol, low density lipoprotein cholesterol, body mass index, triacylglycerol, CAVI is a risk factor of fatty liver. Conclusion: the index of heart and ankle blood vessel is closely related to fatty liver, and the early screening of arteriosclerosis should be paid more attention to in the people who have been screened and found to have fatty liver. This is more conducive to early prevention of cardiovascular disease.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575.5

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