2025 年第 5 期 第 20 卷

血管衰老指标与急性脑梗死早期病情进展的相关性研究

Study on the correlation between vascular senescence indexs and early disease progression of acute cerebral infarction

作者：马琳颖崔啸宇邓春颖郑娇左俊琴刘斌张晋霞

英文作者：Ma Linying Cui Xiaoyu Deng Chunying Zheng Jiao Zuo Junqin Liu Bin Zhang Jinxia

单位：华北理工大学附属医院神经内一科，唐山063000

英文单位：First Department of Neurology North China University of Science and Technology Affiliated Hospital Tangshan 063000 China

关键词：急性脑梗死；病情进展；臂踝脉搏波传导速度；心踝血管指数；踝臂血管指数

英文关键词：Acutecerebralinfarction;Diseaseprogression;Brachial-anklepulsewavevelocity;Cardio-anklevascularindex;Ankle-brachialvascularindex

• 摘要：

• 目的 探讨血管衰老相关指标臂踝脉搏波传导速度（baPWV）、心踝血管指数（CAVI）、踝臂血管指数（ABI）与急性脑梗死（ACI）早期病情进展的相关性。方法 连续入选2023年10月至2024年9月在华北理工大学附属医院神经内科住院的ACI患者280例，根据患者发病7 d内病情进展情况分为进展组(84例)和未进展组(196例)。采用动脉硬化监测装置检测baPWV、CAVI、ABI值，分析三者与ACI早期病情进展的关系，并探讨三者对其预测价值。结果 进展组年龄、体重指数、纤维蛋白原、低密度脂蛋白胆固醇、脂蛋白相关磷脂酶A2大于/高于未进展组(均P<0.05)。进展组的baPWV、CAVI高于未进展组，ABI低于未进展组［（1 275±221）cm/s比（919±124）cm/s、（10.8±0.8）比（9.1±1.1）、（0.82±0.10）比（1.02±0.13）］，差异均有统计学意义（t=13.901、14.729、13.076，均P<0.001）。多因素Logistic回归分析结果显示，baPWV、CAVI、ABI、纤维蛋白原、脂蛋白相关磷脂酶A2是ACI患者早期病情进展的独立影响因素(均P<0.05)，其中的baPWV、CAVI是ACI早期病情进展的危险因素，ABI是保护因素。相关性分析结果显示baPWV、CAVI与ACI早期病情进展呈正相关（r=0.645、0.612，均P＜0.001），ABI与其呈负相关（r=-0.621，P＜0.001）。baPWV、CAVI、ABI及三者联合预测患者早期病情进展的曲线下面积分别为0.906、0.886、0.891、0.946，三者联合检测预测价值更高。 结论 血管衰老相关指标baPWV、CAVI、ABI与ACI早期病情进展密切相关。baPWV、CAVI、ABI均对ACI患者早期病情进展有预测价值，三者联合检测预测价值更高。

• Objective To investigate the correlation between brachial-ankle pulse wave velocity (baPWV), cardio-ankle vascular index (CAVI), ankle-brachial vascular index (ABI) and early disease progression of acute cerebral infarction (ACI). Methods A total of 280 consecutive ACI patients hospitalized in the Department of Neurology, North China University of Science and Technology Affiliated Hospital from October 2023 to September 2024 were enrolled. According to the disease progression within 7 days of onset, the patients were divided into progression group (84 cases) and non-progression group (196 cases). The values of baPWV, CAVI and ABI were detected by arteriosclerosis monitoring device. The relationship between the three indexes and the early progression of ACI was analyzed, and the predictive value of the three indexes was discussed. Results The age, body mass index, fibrinogen, low-density lipoprotein cholesterol and lipoprotein associated phospholipase A2 in the progression group were higher/higher than those in the non-progression group (all P<0.05). The baPWV and CAVI in the progression group were higher than those in the non-progression group, and ABI was lower than that in the non-progression group ［(1 275±221)cm/s vs (919±124)cm/s, (10.8±0.8) vs (9.1±1.1), (0.82±0.10) vs (1.02±0.13)］(t=13.901, 14.729, 13.076, all P<0.001). Multivariate Logistic regression analysis showed that baPWV, CAVI, ABI, fibrinogen and lipoprotein-associated phospholipase A2 were independent influencing factors for early disease progression in patients with ACI (all P<0.05). Among them, baPWV and CAVI were risk factors for the early progression of ACI, and ABI was a protective factor. Correlation analysis showed that baPWV and CAVI were positively correlated with the early progression of ACI (r=0.645, 0.612, both P<0.001), while ABI was negatively correlated with it (r=-0.621, P<0.001). The area under the curve of baPWV, CAVI, ABI and their combination in predicting early disease progression were 0.906, 0.886, 0.891 and 0.946, respectively, and the combined detection of the three had higher predictive value. Conclusion The baPWV, CAVI and ABI are closely related to the early progression of ACI. The baPWV, CAVI and ABI all have predictive value for early disease progression in ACI patients, and the combined detection of the three has higher predictive value.