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目的:研究绝经女性中冠脉钙化积分(CACS)与踝臂指数(ABI)之间的相关性。方法:从1918名社区人群筛选出608名无冠心病病史并可以进行CACS检查的绝经女性为样本,对其进行标准化问卷调查、实验室指标检测、ABI及CACS测量。根据CACS将研究对象分为钙化阴性组和钙化阳性组,并根据ABI结果分为五类:外周血管病组(ABI<0.9)、临界ABI组(ABI:0.90-0.99)、低-正常ABI组(ABI:1.00-1.09)、正常ABI组(ABI:1.10-1.29)和高ABI组(ABI≥1.3),分析不同冠脉钙化程度与不同等级ABI的相关性。结果:研究人群中钙化阴性514例(84.5%),钙化阳性94例(15.5%)。其中钙化阳性组在年龄、高血压、收缩压、总胆固醇、高密度脂蛋白、低密度脂蛋白及糖尿病方面均高于钙化阴性组,同时绝经女性多数集中在低-正常ABI组和正常ABI组,分别为235例(38.7%)和313例(51.5%)。钙化阳性组存在外周血管病变和临界ABI状态者多(5.3%vs.0.8%,9.6%vs.6.4%),两组间差异有统计学意义(P<0.001),并且Logistic回归发现,绝经女性年龄(OR=1.115,95%CI 1.060-1.174,P<0.001)、高血压(OR=1.941,95%CI 1.107-3.402,P=0.021)、收缩压(OR=1.018,95%CI 1.003-1.034,P=0.020)、外周血管病变(ABI<0.9)(OR=6.771,95%CI 1.483-30.923,P=0.014)是冠脉钙化的独立危险因素。高密度脂蛋白(OR=0.322,95%CI 0.104-0.994,P=0.049)则是防止冠脉钙化的有利因素。结论:绝经女性ABI降低与CACS相关,ABI可以作为一种评估冠脉钙化程度和心血管风险的有效手段为临床医生服务。
PURPOSE: To study the association between coronary calcium score (ACS) and ankle brachial index (ABI) in menopausal women. Methods: A total of 608 premenopausal women with no history of coronary heart disease who had a history of coronary heart disease were enrolled from 1918 community-based population. The subjects were surveyed by standardized questionnaires, laboratory tests, ABI and CACS. According to the results of ABI, the subjects were divided into five groups according to CACS: peripheral vascular disease group (ABI <0.9), critical ABI group (ABI: 0.90-0.99), low-normal ABI group (ABI: 1.00-1.09), normal ABI group (ABI: 1.10-1.29) and high ABI group (ABI≥1.3). The correlation between different degree of coronary artery calcification and different grade ABI was analyzed. Results: Among the study population, there were 514 cases (84.5%) with negative calcification and 94 cases (15.5%) with positive calcification. The calcification positive group was higher than calcific negative group in age, hypertension, systolic blood pressure, total cholesterol, high density lipoprotein, low density lipoprotein and diabetes, and the majority of menopausal women concentrated in low-normal ABI group and normal ABI group , Respectively, 235 cases (38.7%) and 313 cases (51.5%). There was a significant difference between the two groups (P <0.001). The Logistic regression analysis showed that there was a significant difference between the two groups (5.3% vs.0.8%, 9.6% vs.6.6% (OR = 1.115, 95% CI 1.060-1.174, P <0.001), hypertension (OR = 1.941,95% CI 1.107-3.402, P = 0.021), systolic blood pressure (OR = 1.018,95% CI 1.003-1.034 , P = 0.020). Peripheral vascular lesions (ABI <0.9) (OR = 6.771, 95% CI 1.483-30.923, P = 0.014) were independent risk factors for coronary artery calcification. High density lipoprotein (OR = 0.322, 95% CI 0.104-0.994, P = 0.049) was a favorable factor in preventing coronary calcification. CONCLUSION: ABI reduction in menopausal women is associated with CACS, and ABI can serve clinicians as an effective measure of coronary artery calcification and cardiovascular risk.