(课件)-测量四肢血压的预测价值_精品.pptVIP

* 通过四肢血压测量，我们可以得到以下3个反映四肢间血液动力学差异的指标，这些指标的差异均表明存在着外周动脉疾病。 * * * * * 我们首先来看看单侧上臂血压与死亡的关系，选择了收缩压高的一侧血压值来进行分析， 在校正年龄、性别、吸烟、饮酒、高血压治疗、糖尿病、血浆总胆固醇以及血压其他成分等混杂因素后，我们只发现平均动脉压与总死亡负相关，其他血压成分与死亡没有关系。因此，在老年自然人群中，单侧的上臂血压的死亡预测价值已经明显降低。 * * * * * * * 测量四肢血压的预测价值 上海交通大学医学院附属瑞金医院 上海市高血压研究所 王继光 jiguangw@ The Shanghai Cardiovascular Health Study (SCHS) The JingNing population study The QingPu population study The QingPu study in the elderly The NingBo study in the workplace setting * baPWV and mortality * SCHS: Objective To investigate the prognostic significance of four-limb blood pressure for total and CV mortality in an elderly (?60 years) Chinese population. Sheng CS, et al. Hypertension 2013; 61:1155-60. * SCHS: Study population We invited all residents of 60 years or older from villages and communities of a town in the suburb of Shanghai, 30 km from the city centre, to participate in cardiovascular health examinations. Our study started in 2006 on subjects in the age range from 60 to 69 years, and then in 2007 on subjects of 70 years or older. These subjects were followed up for events, and repeated examinations were performed once every 2 years. Sheng CS, et al. Hypertension 2013; 61:1155-60. * OMRON VP-1000 SCHS: Four-limb BP and pulse wave velocity Four-limb BP for the calculation of BP differences and ratios, eg, ankle-brachial index (ABI) Pulse wave velocity (brachial-ankle) * 四肢血压 上臂血压 踝臂指数 (ABI) = 较低一侧踝部血压/较高一侧肱动脉血压 双臂间血压差值 = ?左臂血压?右臂血压 ? 双踝间血压差值 = ?左踝血压?右踝血压 ? Sheng CS, et al. Hypertension 2013; 61:1155-60. * Means and proportions were compared with the student t-test and Fisher’s exact test, respectively. Multiple Cox regression analyses were used to determine the hazard ratios of total and CV mortality with 4-limb BP ratios and difference, while controlling for covariates. The log-rank test was used to compare the cumulative incidence of mortality between groups, with Kaplan-Meier survival curve to show the time to deaths. The C-statistic anal