摘要
目的基于可视化血压测量中动态柯氏音趋势(DKT)图数据分析心血管功能状态与寻常型银屑病(PV)的相关性。方法选取2021年7月14日-8月31日于空军特色医学中心皮肤科门诊就诊和病房住院的52例PV患者(设为PV组),另选取2021年8月2日-8月31日于空军特色医学中心健康体检中心体检的51名健康者作为健康对照组,进行血常规检测及可视化血压测量。收集并比较两组一般资料、血压相关指标以及系统性炎症指标中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR);采用Pearson检验分析PV患者各血压指标与临床因素之间的关系,单因素和多因素logistic回归分析PV发病的影响因素,受试者工作特征(ROC)曲线分析各因素对PV发病的预测价值及临界值。结果对干扰因素进行校正后,与健康对照组比较,PV患者的外周血PLR、NLR以及心脏射血能力(收缩压、K-D)、外周小动脉阻力(舒张压、平均压)、血管硬化程度(K-A)明显升高(P<0.05),主动脉和大动脉血管弹性(脉压差)以及自主神经对血压稳定性的控制能力(DKT图形态)明显下降(P<0.05)。多因素logistic回归分析显示,体重指数、PLR、收缩压、DKT图形态为PV发病的独立危险因素(OR=1.270、1.014、1.078、6.084,P<0.05)。ROC曲线分析显示,收缩压(AUC=0.798,P<0.001)、平均压(AUC=0.748,P<0.001)、脉压差(AUC=0.719,P=0.001)、舒张压(AUC=0.696,P=0.002)、NLR(AUC=0.718,P=0.001)、PLR(AUC=0.716,P=0.001)、K-D(AUC=0.637,P=0.030)、DKT图形态(AUC=0.638,P=0.029)为PV发病的预测指标,其临界值分别为109 mmHg、86 mmHg、35 mmHg、86 mmHg、1.3、97、68、形态2。结论基于DKT图数据,PV患者心血管功能存在异常,且与PV的发生及严重程度相关。心血管功能异常以及系统性炎症指标NLR和PLR对PV的发生具有预测意义。
Objective To study and evaluate the cardiovascular function of patients with psoriasis vulgaris(PV)by analyzing the dynamic Korotkoff's sound trend diagram data from visual blood pressure measurements.Methods A total of 52 PV patients,visiting and/or admitted in the Department of Dermatology of Air Force Medical Center of PLA during July 14 to August 31,2021,were recruited as PV group,and another 51 examiners in the Health Examination Center of Air Force Medical Center of PLA during August 2-31,2021 were levied as healthy control group.Routine blood tests and visual blood pressure measurements were performed.The general data blood pressure indicators and systemic inflammatory indicators neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)of the two groups were collected and compared.Pearson correlation analysis was used to analyze the relationship between the clinical factors and blood pressure indicators in PV patients,univariate and multivariate logistic regression analysis was used to analyze the related factors of PV incidence,and receiver operating characteristic(ROC)curve was used to analyze the predicted value and cut-off value of each factor in PV incidence.Results After adjustment of interference factors,compared with the healthy control group,the peripheral blood PLR,NLR,cardiac ejection ability(systolic blood pressure,K-D),peripheral arteriole resistance(diastolic blood pressure,mean blood pressure)and degree of vascular sclerosis(K-A)increased significantly in PV patients(P<0.05),and the vascular elasticity of aorta and great artery(pulse pressure difference)and the ability of autonomic nerve to control blood pressure stability(DKT morphology)were decreased significantly(P<0.05).Multivariate logistic regression analysis showed that BMI,PLR,systolic blood pressure,DKT morphology were the independent risk factors for PV(OR=1.270,1.014,1.078,6.084,P<0.05).ROC curve analysis showed that systolic blood pressure(AUC=0.798,P<0.001),mean blood pressure(AUC=0.748,P<0.001),pulse pressure difference(AUC=0.719,P=0.001),diastolic blood pressure(AUC=0.696,P=0.002),NLR(AUC=0.718,P=0.001),PLR(AUC=0.716,P=0.001),K-D(AUC=0.637,P=0.030),and DKT morphology(AUC=0.638,P=0.029)were the early predicted indicators of PV,the cut-off values are 109 mmHg,86 mmHg,35 mmHg,86 mmHg,1.3,97,68 and morphology 2,respectively.Conclusion Based on DKT,PV patients have abnormal cardiovascular function,which is related to the occurrence and severity of PV.Abnormal cardiovascular function and systemic inflammatory indexes NLR and PLR have early predictive significance for the occurrence of PV.
作者
杨明祎
庞晓文
王健康
梁斌
郝冰
唐爱萍
俞梦孙
Yang Ming-Yi;Pang Xiao-Wen*;Wang Jian-Kang;Liang Bin;Hao Bing;Tang Ai-Ping;Yu Meng-Sun(The First Clinical Medical College of Nanjing Medical University,Nanjing,Jiangsu 211166,China;Department of Dermatology,Air Force Medical Center of PLA,Beijing 100142,China;Pharmaceutical Clinical Trial Institute,Air Force Medical Center of PLA,Beijing 100142,China;Health Examination Center,Air Force Medical Center of PLA,Beijing 100142,China;Aeromedicine Engineering Research Center,Air Force Medical Center of PLA,Beijing 100142,China)
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2022年第12期1248-1255,共8页
Medical Journal of Chinese People's Liberation Army
关键词
寻常型银屑病
心血管功能
血压
动态柯氏音趋势图
炎症
psoriasis vulgaris
cardiovascular function
blood pressure
dynamic Korotkoff's sound trend diagram
inflammation
