与战斗相关的创伤性截肢和亚临床心血管风险之间的关系
Christopher J Boos1, Susie Schofield2, Anthony M J Bull3
1Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall Estate, Near Loughborough, Nottinghamshire LE12 5QW, United Kingdom of Great Britain and Northern Ireland; The Academic Department of Military Mental Health, King's College London, SE5 9RJ, United Kingdom of Great Britain and Northern Ireland; Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, United Kingdom of Great Britain and Northern Ireland; Department of Cardiology, University Hospitals Dorset, Poole Hospital, Poole BH15 2JB, United Kingdom of Great Britain and Northern Ireland.
战斗伤害和截肢显著降低冠状动脉流量储备,增加退伍军人的心血管风险. 这突显了战斗创伤对心脏健康的长期健康影响.
科学领域:
- 心血管科学 心血管科学
- 创伤医学 创伤医学
- 军人卫生保健 军人卫生保健
背景情况:
- 与战斗有关的创伤伤害 (CRTI) 对冠状动脉流量储备 (CFR) 和亚临床心血管风险的影响尚不清楚.
- 这项研究通过检查创伤性肢体截肢的退伍军人来弥补这一差距.
研究的目的:
- 调查CRTI,特别是创伤性截肢,和CFR之间的关系.
- 评估英国战斗退伍军人的亚临床心血管风险标志物.
主要方法:
- 与受伤的非截肢者 (n=418) 和未受伤的退伍军人 (n=565) 进行了英国战斗退伍军人与创伤性肢体截肢者的比较 (n=161).
- 测量了亚临床心血管风险,使用了血动脉基因指数 (AIP),甘油三糖指数 (TyG),中性粒细胞-淋巴细胞比率 (NLR),hs-CRP,BMI,内脏脂肪和6分钟的步行距离 (6MWD).
- 通过动脉脉冲波形分析使用下内心活力比率 (SEVR) 估计的CFR.
主要成果:
- 截肢者表现出明显更高的AIP,TyG,NLR,hs-CRP,BMI和内脏脂肪,与受伤的非截肢者和未受伤的群体相比,SEVR和6MWD较低.
- 下部SEVR在膝盖以上或多肢截肢的退伍军人中最为明显.
- 即使对共变量进行调整后,CRTI和截肢都与减少的SEVR独立相关.
结论:
- 与战斗有关的创伤和截肢与冠状动脉流量储备的减少有关.
- 经历创伤性截肢的退伍军人表现出亚临床心血管风险增加.
- 与截肢相关的身体缺陷恶化与较差的心血管结果相关.
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