The Research On The Relationship Of Coronary Artery Calcium And Pulse Pressure Difference And The Risk Factors Clustering Of The Village Population In Yunnan

Objectives on the basis of knowing the coronary artery calcification(CAC)and the coronary artery calcification score(CACS) in rural natural crowdin Yunnan, to further discuss the relationship of coronary artery calciumand pulse pressure difference and the risk factors clustering.Materials and methods use the randomly stratified cluster samplingmethod, first selected840people who are51-71years old form fourcounties of eleven villages, which is Yongping, Yongsheng, Yulong andWeixi, exclulding the people who was giving up medical, gonging out anddate loss, we were all surveying640people, there were212objects goingto do test examination and heart scan with Philips16Multi-detectorComputed Tomography(16-MDCT). Specialized training investigators gonethe home of the study objects or the local village committee forinvestigation questionnaire and physical examination, and took theobjects who willing to do further laboratory tests to clinical laboratoryof Dali college affiliated hospital, and took the heart16-MDCTexamination after signed the informed consent, collected the data, andentried the data to database. Use the SPSS11.5software to analysis thestatistics, use mean±standard deviations to express measurement data,use rate and constituent ratio to express count data,if the data conformsto normal distribution and variance together, using two independentsample t-test or t,-test to compare the two samples measurement data,using variance of analysis to compare the multiple samples mean, usingthe linear correlation analysis to analyse the correlation analysisbetween variables. if the data conforms to skewed distribution or varianceis not together, the comparision of sample mean use nonparametric test(rank and inspection or Kruskal Wallis H nonparametric test), correlationanalysis use the Spearman rank correlation analysis, rate and compositionratio compared with chi-square test or rank sum test, p values for both sides, according to the rate of alpha=0.05inspection level, p<0.05forthe difference was statistically significant.Results There are107(50.5%) men in212study objects, average pulsepressure difference is46.96±16.52mmHg, there are105(49.5%) women,average pulse pressure difference is47.62±15.34mmHg, the differenceof average pulse pressure difference between men and women is nostatistical difference. There are108(50.9%) cases in51to60age group,the average pulse pressure difference is44.67±13.87mmHg, there are104(49.1%) cases in61to71age group, the average pulse pressuredifference is50.00±17.44mmHg, pulse pressure difference is differencein different age group, the pulse pressure difference in61-71age groupis greater than51to60age group, difference is statisticallysignificant (P=0.015). Analyse the correlation of age and pulse pressuredifference, shows that the pulse pressure difference is positivelycorrelated with age (rs=0.202, P=0.202), we can think pulse pressuredifference increased with the increase of age. The pulse pressuredifference between the objects whose calcification is positive and theobjects whose calcification is negative is no statistical difference (P=0.501), pulse pressure difference>60mmHg is pulse pressure differenceincrease, increasing rate(26%) of the objects whose calcification ispositive is higher than the objects whose calcification is negative(17.3%),but it is no statistical difference (P=0.173).Divide the212cases into three groups by CACS（CACS＜1、1≤CACS＜100、CACS≥100）, pulsepressure difference>60mmHg is pulse pressure difference increase, tocompare different CACS group average pulse pressure difference and pulsepressure difference increasing rate, shows that: the average pulsepressure difference and pulse pressure difference increasing rate inthree groups is different, the average pulse pressure difference（55.22±18.79mmHg）and pulse pressure difference increasing rate（47.1%）inCACS≥100group is higher than CACS＜1group and1≤CACS＜100group, thedifference is statistical significance（P＜0.05）, CACS＜1group and1≤CACS＜100group is no statistical difference.Divide the pulse pressuredifference into normal pulse pressure difference group（40mmHg group）,alittle bit high pulse pressure difference（41-60mmHg group）,high pulsepressure difference group(＞60mmHg group),to analyse the correlation ofpulse pressure difference and CACS in the objects whose calcification ispositive, use spearman rank correlation analysis, the result shows thatthe pulse pressure difference and CACS were positively correlated, theCACS increases with the increase of pulse pressure difference.To comparethe pulse pressure difference in different calcified vascular count group,the result shows that average pulse pressure difference in differentcalcified vascular count group is different, which the average pulsepressure difference in more calcified vascular count group is higher thansingle calcified vascular group and no calcified vascular group, difference is statistically significant(P=0.01,P=0.008).There are only28(13.2%) research objects have no risk factor in212research objects,there are87(41.0%) cases have one risk factors, there are97(45.8%) caseshave two or more than two risk factors. Different sex have different riskfactors concentration distribution, the level0risk factor concentrationdistribution detection rate is higher in female than male, the level1and level2risk factor concentration distribution detection rate ishigher in male than female, difference is statisticallysignificant(P=0.000).Level2risk factor concentration distributiondetection rate is higher in61to71age group than51to60age group,but the difference is no statistically significant(p=0.052).The riskfactor concentration distribution is no difference between the researchobjects whose calcification is positive and the research objects whosecalcification is negative(P=0.707).The CACS in different level riskfactor concentration distribution do not founddifference(H=0.303,P=0.860).We can not find the CACS increased with therisk factor concentration distribution increase moreover.Conclusion the pulse pressure difference of rural natural populationsin Yunnan is associated with CACS, which is the risk factor of coronaryheart disease. The pulse pressure difference is increased as CACS increasein the research objects whose calcification is positive, and we find thatthe pulse pressure difference is different in different calcifiedvascular count group, more calcified vascular count group is greater thansingle calcified vascular group and no calcified vascular group. We cannot find that level risk factor concentration distribution is differentin the different calcification situation and the CACS increased with therisk factor concentration distribution increase.