增益指数检测在高血压健康管理中的应用
Application of augmentation index in health control of hypertension patients
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摘要: 目的 研究桡动脉反射波增益指数(Augmentation Index,AI)水平与高血压患者心脏舒张功能、肾脏功能之间关系,探讨AI水平变化在高血压健康管理评价中的作用。方法 对符合入选条件的105例高血压患者进行桡AI、proBNP水平测定、肾脏功能测定及超声心动图检查,并进行相关分析,绘制AI的受试者特征曲线并评价其在心脏舒张功能不全中的作用。结果 proBNP水平升高组患者AI水平明显增加,而肾功能减退组患者AI水平相应增加,proBNP与AI正向相关,相关系数0.3697(P=0.003)。肌酐清除率与AI水平之间存在负相关,相关系数为-0.348(P<0.05)。受试者工作特征曲线提示以AI诊断舒张功能不全的最佳临界值为85.5,该点灵敏度0.909,特异度0.889。结论 桡动脉AI水平变化反映高血压患者心脏舒张功能状态的变化,亦能体现高血压肾脏功能状态的改变,可作为高血压健康管理的动态随访无创性指标。Abstract: Objective To investigate the correlation of Augmentation Index(AI)with diastolic cardiac and renal function in patients with hypertension and the role of AI in health control of hypertension patients. Methods AI and prosome brain natriuretic peptide(proBNP)levels were measured in 105 hypertension patients with their renal and cardiac functions determined by echocardiography.The correlation between these parameters was analyzed.Receiver operating characteristic(ROC)curves were plotted. Results The AI level was significantly elevated in patients with a higher proBNP level and relatively elevated in patients with renal dysfunction,the correlation coefficient for AI and proBNP was 0.369 7(P=0.003).The creatinine clearance rate was negatively correlated with AI level and their correlation coefficient was-0.348(P<0.05).ROC curves showed that the maximal clinical value of AI for the diagnosis of cardiac diastolic dysfunction was 85.5% with a sensitivity of 0.909 and a specificity of 0.889. Conclusion Changes in radial AI level can reflect the corresponding changes in cardiac diastolic and renal function in patients with hypertension,suggesting that AI can be used as a non-invasive dynamic indicator for the health control of hypertension patients during follow-up.
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