過去的研究已知手臂動脈擴張度(brachial arterial distensibility)可反映動脈血管硬度(arterial stiffness)，因此被建議使用於心血管病風險的評估。但針對外表健康的無症狀族群，使用手臂動脈擴張度來評估心血管病風險的研究則不多。本研究之目的即在探討以手臂動脈擴 張度預測此一族群未來發生心血管病風險的能力，同時探討手臂動脈擴張度與各種心血管 病危險因子間的關聯性與影響測定手臂動脈擴張度的因素。本研究選取300位(男性152位，女性148位，平均年齡52±13歲)自願來院做健康檢查，外觀正常且無臨床症狀者，詳細記錄其血壓、身高、體重、家族病史、各種心血管病危險因子、抽血測定血脂肪、血脂 蛋白及空腹血糖、並使用DynaPulse 2000A型機器測量其手臂動脈擴張度。最後吾人使用Framingham心血管病風險評估計分表來計算每人未來十年發生心血管病的風險，並統計分析手臂動脈擴張度是否能預測此風險。本研究發現手臂動脈擴張度與各種心血管病危險因子，包括：年齡、血壓、身高、體質量指數(body mass index)、總膽固醇、低密度脂蛋白膽 固醇及空腹血糖等之間確有顯著之相關性。多變項分析則顯示影響手臂動脈擴張度測量値 的主要決定因素是年齡、血壓及空腹血糖值。手臂動脈擴張度與參加者依Framingham心血管病風險評估表計算所得的分數間成明顯負相關(r=-0.45, P<0.0001)。吾人進一步將參加 者依換算所得的十年内心血管病風險分爲低風險組(其十年內心血管病風險<10%)及中等風險組(其十年內心血管病風險≧10%)，結果前組之手臂動脈擴張度數値明顯高於後組(6.12±1.25%/mmHg vs.4.94±1.2%/mmHg, P=0.0001)。以非侵入方式測量手臂動脈擴張度應有助於評估此族群將來發生心血管病之風險。

Previous studies have shown that brachial arterial distensibility (BD) is a measure of arterial stiffness and may be used in risk assessment for cardiovascular disease (CVD). The aim of this study was to explore the predictive value of BD for CVD risk levels and to seek cardiovascular risk factors influencing BD. In this study, BD data were obtained using the DynaPulse 2000A instrument (Pulse Metric, Inc, USA) in 300 asymptomatic, apparently healthy subjects (M/F=152/148; aged 52±13 years) who were admitted for routine physical check-up. Family history, serum lipids and lipoproteins, glucose levels and mercury sphygmomanometer blood pressure measurements were obtained. The risk for CVD in each individual was assessed using the Framingham Risk Score system. Significant correlations
were found between unadjusted BD and age, measures of blood pressure, height, body mass index, total cholesterol levels, LDL-cholesterol levels, and glucose levels. Multivariate regression analyses showed that age, systolic and diastolic blood pressures and glucose levels independently predicted changes in BD. There was a significantly negative correlation between BD and the Framingham risk scores ( r = -0.45, P <0.0001 ). Subjects with a 10-year risk for a future coronary heart disease events
of <10% had significantly higher BD than those whose risk for coronary heart disease was ≧10% (6.12±1.25 %/mmHg vs. 4.94±1.2 %/mmHg, P= 0.0001). These findings indicate that non-invasive measures of BD are effective in assessing CVD risk. ( J Intern Med Taiwan 2005; 16: 1-10 )