摘要
目的:系统评价原发性醛固酮增多症(PA)患者主要的心血管事件风险相关指标的影响。方法:系统检索PubMed、Web of Science、EMBASE等数据库,寻找PA与颈总动脉内膜中层厚度(CCA-IMT)、颈动脉斑块患病率、血流介导的舒张功能(FMD)、脉搏波传导速度(PWV)、反射波增强指数(AIx)等检测指标相关的文献。结果:共纳入12篇病例对照研究(病例组445例,对照组472例)。PA与原发性高血压病相比,其CCA-IMT明显增厚[MD:0.12 mm;95%CI:(0.09,0.16);P<0.000 01],且大动脉PWV增快[MD:1.39 m/s;95%CI:(0.90,1.87);P<0.000 01],相反,其AIx和心率75次/min时标准反射波增强指数(AIx HR75)无显著差异。与血压正常的人群相比,PA患者CCA-IMT显著增厚[MD:0.16mm;95%CI:(0.05,0.27);P=0.004],大动脉PWV明显增快[MD:3.74m/s;95%CI:(3.43,4.05);P<0.000 01],AIx HR75增高[MD:8.59%;95%CI:(0.69,16.50);P=0.03],而FMD显著降低[MD:-2.52%;95%CI:(-3.64,-1.407);P<0.000 1]。meta回归模型显示糖尿病、吸烟等因素对观察结果有一定影响。结论:PA患者与亚临床动脉粥样硬化和心血管风险因素具有明显的关联性,这一发现有助于在临床工作中建立更有效的心血管事件防控策略。
Objective：To systematically evalate primary aldosteronism patients in major cardiovascular event risk index increased.Method：We system retrieval the PubMed,Web of science,EMBASE database,search for primary aldosteronism disease and common carotid artery intima-media thickness（IMT）,carotid artery plaque prevalence rate,flow mediated dilation（FMD）,pulse-wave velocity（PWV）and augmentation index（AIX）related indexes in the literature.Result：This study included 12 case control studies（445cases,472controls）.Primary aldosteronism increased in patients with primary hypertension compared,the IMT thickening（MD：0.12 mm;[95%CI：0.09,0.16];P〈0.000 01）,and aortic-PWV higher（MD 1.39 m/s;95%CI 0.90,1.87];P〈0.000 01）.On the contrary,the AIx and AIx HR75（heart rate of 75 times per minute standard reflected wave augmentation index）had no significant difference.Compared to those with normal blood pressure,PA patients with CCA-IMT significantly thickened（MD 0.16mm;[95%CI：0.05,0.27];P=0.004）,aortic-PWV was significantly increased（MD 3.74 m/s;[95%CI：3.43,4.05];P〈0.000 01）,higher in AIx HR75（MD 8.59%;[95%CI：0.69,16.50];P=0.03）and FMD was significantly lower（MD-2.52%;95%CI：[-3.64,and-1.407];P〈0.000 1）.Meta-regression model showed that diabetes,smoking and other factors have a certain impact on the observation results.Conclusion：Primary aldosteronism patients and subclinical atherosclerosis and cardiovascular risk factors have obvious relevance.This find helps to building in the clinical work more effective cardiovascular prevention and strategies.
作者
姚克铖
邹秀兰
曾令海
贺茜
易偲
YAO Kecheng ZOU Xiulan ZENG Linghai HE Qian YI Cai(Department of Gerontology Department of Cardiology, Renmin Hospital of Three Gorges University, The First People＇s Hospital of Yichang, Yichang,Hubei, 443002, China)
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2016年第11期1122-1128,共7页
Journal of Clinical Cardiology
基金
2016年三峡大学研究生科研创新基金项目(No:SDYC2016090)
