中国全科医学2025，Vol.28Issue(32)：4061-4066,6.DOI:10.12114/j.issn.1007-9572.2025.0033
肱踝脉搏波传导速度和血清总胆固醇及N末端B型脑钠肽前体联合检测对原发性高血压患者发生冠心病的预测价值研究
The Predictive Value of Combined Detection of Brachial-ankle Pulse Wave Velocity,Serum Total Cholesterol and N-terminal Pro-B-type Natriuretic Peptide for Coronary Heart Disease in Patients with Essential Hypertension
摘要
Abstract
Background Primary hypertension is a critical risk factor for coronary heart disease(CHD),with approximately 20%of patients comorbid with CHD and a doubled risk of cardiovascular events.Traditional prediction models relying on single indicators exhibit limitations.Objective To evaluate the predictive power of combined brachial-ankle pulse wave velocity(baPWV),serum total cholesterol(TC),and N-terminal pro-B-type natriuretic peptide(NT-proBNP)detection for CHD risk in patients with primary hypertension.Methods A total of 310 patients with primary hypertension admitted to the Department of Integrative Cardiology of China-Japan Friendship Hospital from September 2020 to January 2022 were included.Based on CHD comorbidity,patients were divided into a hypertension-only group(n=116)and a hypertension-CHD group(n=194).General clinical data,baPWV,serum TC,and NT-proBNP levels were collected.Binary Logistic regression analysis identified independent risk factors for CHD,and receiver operating characteristic(ROC)curves was used to assess the predictive efficacy of single and combined indicators.Results The hypertension-CHD group exhibited significantly higher baPWV,TC,and NT-proBNP levels compared to the hypertension-only group(P<0.05).Binary Logistic regression analysis revealed that baPWV(OR=1.016,95%CI=1.001-1.031),TC(OR=2.723,95%CI=1.648-4.498),and NT-proBNP(OR=1.006,95%CI=1.001-1.010)were independent risk factors for CHD(P<0.05).ROC analysis showed that the areas under the curve(AUCs)for baPWV,TC,and NT-proBNP in predicting CHD were 0.647,0.760,and 0.693,respectively(P<0.05).Combined detection achieved the highest AUC of 0.825(P<0.05).Conclusion The multidimensional model integrating baPWV(vascular elasticity),TC(lipid metabolism),and NT-proBNP(myocardial injury)significantly improves CHD risk identification in hypertensive patients(AUC>0.8).This noninvasive combined detection strategy serves as a complementary risk stratification tool to traditional coronary angiography,offering evidence-based insights for early intervention.关键词
原发性高血压/冠心病/肱踝脉搏波传导速度/总胆固醇/N末端B型脑钠肽前体Key words
Essential hypertension/Coronary disease/Brachial-ankle pulse wave conduction velocity/Total cholesterol/N-terminal pro-B-type natriuretic peptide分类
医药卫生引用本文复制引用
代天顾,何清,高雪菲,张高钰,樊佳溶,王子涵,肖响,李琳..肱踝脉搏波传导速度和血清总胆固醇及N末端B型脑钠肽前体联合检测对原发性高血压患者发生冠心病的预测价值研究[J].中国全科医学,2025,28(32):4061-4066,6.基金项目
中央高水平医院临床科研业务费资助(2023-NHLHCRF-YXHZ-ZRMS-01,2022-NHLHCRF-YXHZ-03) （2023-NHLHCRF-YXHZ-ZRMS-01,2022-NHLHCRF-YXHZ-03）
中日友好医院"菁英计划"人才培育工程(ZRJY2021-TD03) （ZRJY2021-TD03）
北京市自然科学基金资助项目(7232320) （7232320）
