乌鲁木齐市12 375名体检人群脉压指数、体质指数与脑血流动力学的相关性分析

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目的:探讨及分析脉压指数、体质指数与脑血流动力学的相关性,并评估其在脑卒中早期筛查中的意义。方法:选取2018年1—12月在新疆医科大学第一附属医院完成脑血流功能检测的体检人群为研究对象。首先通过现场问卷获取调查对象基本情况及疾病史;测量身高、体重、血压,并计算体质指数、脉压、脉压指数及平均动脉压;同时完成脑血流动力学监测。脑血流动力学指标高于≥75分为脑血管功能正常组,<75分为异常组。将研究对象按脉压指数分为高、中、低3个亚组,按体质指数分为体重过低组、正常组、超重组、肥胖组4个亚组,分别计算和比较不同组脉压指数水平及体质指数水平与脑血流动力学的相关性。结果:共纳入研究对象12 375人,年龄为(52.6±7.3)岁,男性7 275人(58.79%),女性5 100人(41.21%)。脑血管功能正常组9 900人(80.00%),异常组2 475例(20.00%)。汉族、有高血压病史、糖尿病病史、高血脂病史者脑血流动力学指标的异常率更高,且脑血流动力学指标异常组体质指数、收缩压、舒张压、脉压、脉压指数、平均动脉压均高于正常组(n P均<0.001)。在不同脉压指数亚组中,左右侧平均血流量、平均流速、最大流速、最小流速、临界压水平随着脉压指数水平的上升呈下降趋势,外周阻力、脉搏波速、特性阻抗、动态阻力、舒张压与临界压的差值均随脉压指数水平上升呈上升趋势;在不同体质指数组中,肥胖组左侧平均血流量均低于过低组、正常组和超重组;肥胖组右侧平均血流量均低于正常组和超重组,且高于过低组。左右侧平均流速、最大流速、最小流速随着体质指数水平的上升呈下降趋势;外周阻力、脉搏波速、特性阻抗、动态阻力、临界压水平、舒张压与临界压的差值随体质指数水平上升呈上升趋势,差异均具有统计学意义(n P均<0.001)。非条件多因素Logistic回归分析结果显示汉族、有高血压病史、有糖尿病病史、脉压指数、体质指数是脑血流动力学指标异常的危险因素,脉压指数、体质指数越高,脑血流异常的风险越高。n 结论:脉压指数、体质指数水平越高,脑血流动力学指标异常的可能性越高,当出现过高的脉压指数及体质指数时,应引起高度重视。在关注脑血流动力学指标的同时,应对于脑血流动力学指标单项异常参数予以重视和纠正,最终实现有效预防脑卒中的目的。“,”Objective:This study aimed to explore and analyze the correlation between pulse pressure index (PPI), body mass index (BMI), and cerebral hemodynamics and evaluate their significance in early screening for stroke.Methods:The subjects were selected from those who had completed the cerebral blood flow function test in the First Affiliated Hospital of Xinjiang Medical University from January to December 2018. First, basic information and disease history of the respondents were obtained through on-site questionnaire survey. Height, weight, and blood pressure were measured, and BMI, pulse pressure, PPI, and mean arterial pressure were calculated. Meanwhile, cerebral hemodynamic monitoring was completed. Individuals with cerebral hemodynamic indexes ≥75 were classified as normal cerebrovascular function group and those with cerebral hemodynamic indexes <75 as abnormal group. This study divided the PPI into three subgroups: high, medium, and low. According to the Chinese Adult Overweight and Obesity Prevention and Control Guidelines, the BMI was divided into too low, normal, overweight, and obese. The correlations of PPI and BMI with cerebral hemodynamics in different groups were calculated and compared.Results:A total of 12 375 subjects, aged (52.6±7.3) years, were included in the study, consisting of 7 275 men (58.79%) and 5 100 women (41.21%). There were 9 900 patients (80.00%) in the normal group and 2 475 patients (20.00%) in the abnormal group. The abnormal rate of cerebral hemodynamics was higher in the Han nationality; those with a history of hypertension, diabetes, and hyperlipidemia. Moreover, those with abnormal cerebral hemodynamic indicators had a higher BMI, systolic pressure, diastolic pressure, pulse pressure and PPI, mean arterial pressure was higher than the normal group (all n P<0.001). In different PPI groups, the average blood flow, average velocity, maximum velocity, minimum velocity, and critical pressure level of the left and right sides showed a downward trend with the increase in PPI. Peripheral resistance, pulse wave velocity, characteristic impedance, dynamic resistance, and difference between diastolic and critical pressure all showed an upward trend with the increase in PPI. In different BMI groups, the average blood flow in the obese group on the left side was lower than that in the underweight, normal, and super recombination groups. The average blood flow in the obese group on the right side was lower than that in the normal and super recombination groups and higher than that in the subhypoxia group. The mean, maximum, and minimum velocities of the left and right sides decreased with the increase in BMI. The differences in peripheral resistance, pulse wave velocity, characteristic impedance, dynamic resistance, critical pressure level, diastolic blood pressure, and critical pressure showed an increasing trend with the increase in BMI, and the differences of the above indicators were statistically significant (alln P <0.001).The results of unconditional multivariate logistic regression analysis showed that Han nationality, history of hypertension, history of diabetes, PPI, and BMI were the main risk factors for abnormal cerebral hemodynamics. The higher the PPI and BMI, the higher the risk of abnormal cerebral blood flow.n Conclusion:The higher the PPI and BMI, the higher the possibility of abnormal cerebral hemodynamic indexes. Extremely high PPI and BMI should be paid greater attention.
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