[ppt]-测量四肢血压的预测价值

测量 四肢 血压 的预测价值上海交通大学医学院附属瑞金医院上海市高血压研究所王继光 The Shanghai Cardiovascular Health Study (SCHS) n The JingNing population studyn The QingPu population studyn The QingPu study in the elderly n The NingBo study in the workplace setting baPWV and mortalitySCHS: Objective To investigate the prognostic significance of four-limb blood pressure for total and CV mortality in an elderly (60 years) Chinese population. Sheng CS, et al. Hypertension 2013; 61:1155-60.SCHS: Study population n We invited all residents of 60 years or older from villages and communities of a town in the suburb of Shanghai, 30 km from the city centre, to participate in cardiovascular health examinations. n Our study started in 2006 on subjects in the age range from 60 to 69 years, and then in 2007 on subjects of 70 years or older. These subjects were followed up for events, and repeated examinations were performed once every 2 years. Sheng CS, et al. Hypertension 2013; 61:1155-60.OMRON VP-1000SCHS: Four-limb BP and pulse wave velocity1. Four-limb BP for the calculation of BP differences and ratios, eg, ankle-brachial index (ABI)2. Pulse wave velocity (brachial-ankle)四肢血 压u 上臂血 压 u 踝臂指数 (ABI) = 较 低一 侧 踝部血 压 /较 高一 侧 肱 动 脉血压u 双臂 间 血 压 差 值 = 左臂血压 右臂血压 u 双踝 间 血 压 差 值 = 左踝血压 右踝血压 Sheng CS, et al. Hypertension 2013; 61:1155-60. Means and proportions were compared with the student t-test and Fishers exact test, respectively. Multiple Cox regression analyses were used to determine the hazard ratios of total and CV mortality with 4-limb BP ratios and difference, while controlling for covariates. The log-rank test was used to compare the cumulative incidence of mortality between groups, with Kaplan-Meier survival curve to show the time to deaths. The C-statistic analysis was performed to examine the incremental prognostic value for mortality.Statistical methods Sheng CS, et al. Hypertension 2013; 61:1155-60.研究结果General outline of the study Number of participants: 3133 Median follow-up time: 4.0 years Cumulative number of person-years: 12,500 Number of total deaths: 203 Number of CV deaths: 93 (CHD, CHF and stroke)Sheng CS, et al. Hypertension 2013; 61:1155-60.基线特征 (1)Characteristic Men (n=1383) Women (n=1750) P valueAge, years 68.57.2 69.37.5 0.005Body mass index, kg/m2 23.43.4 23.83.7 0.002Systolic pressure, mm Hg 136.518.6 141.320.2 0.9All mortalityCV mortalityNo. of event / No. on riskRate per 1000 p-yrs2.02 (1.24-3.30)1.70 (0.86-3.39)* Adjusted for age, sex, body mass index, current smoking, current alcohol intake, systolic and diastolic blood pressure, hypertension treatment, diabetes mellitus, and serum total cholesterol.ABI0.95 ABI0.95All mortalityCV mortality39/175 55.822/175 31.5164/2958 13.971/2958 6.02.23 (1.52-3.26)2.12 (1.24-3.64)Sheng CS, et al. Hypertension 2013; 61:1155-60.双臂 间 血 压 差 Total mortality CV mortalityHR (95%CI)* P value HR (95%CI)* P valueSystolic (+3.76 mmHg) 1.16 (1.04-1.30) 0.01 1.18 (1.01-1.40) 0.04Diastolic (+3.07 mmHg) 1.17 (1.05-1.31) 0.005 1.23 (1.06-1.44) 0.006* The analyses were adjusted for age, sex, body mass index, current smoking, current alcohol intake, use of antihypertensive drugs, diabetes mellitus, serum total cholesterol, and arm systolic and diastolic blood pressure.双臂间血压差值预测价值Sheng CS, et al. Hypertension 2013; 61:1155-60.双臂间血压差值预测价值Total mortalitySheng CS, et al. Hypertension 2013; 61:1155-60.Event Relative risk (95% CI)0.5 1 2 4 821/199 25.59/199 10.9182/2934 15.5 84/2934 7.210 mmHgAll mortalityCV mortalityNo. of event / No. on riskRate per 1000 p-yrs1.72 (1.06-2.80)1.45 (0.70-3.00)* Adjusted for age, sex, body mass index, current smoking, current alcohol intake, systolic and diastolic blood pressure, hypertension treatment, diabetes mellitus, and serum total cholesterol.All mortalityCV mortality9/55 40.34/55 17.9194/3078 15.889/3078 7.22.47 (1.24-4.93)2.11 (0.75-5.96)双臂间血压差值预测价值0.9)Total mortality CV mortalityHR (95% CI)* P value HR (95% CI)* P valueInter-arm BP difference, mm Hg 10 vs 10 1.44 (0.78-2.65) 0.24 1.29 (0.50-3.31) 0.5915 vs 15 2.04 (0.74-5.65) 0.17 2.36 (0.54-10.29) 0.25Inter-ankle BP difference, mm Hg10 vs 10 1.63 (1.17-2.27) 0.004 1.70 (1.05-2.77) 0.0315 vs 15 1.82 (1.18-2.80) 0.006 1.86 (1.02-3.40) 0.04Sheng CS, et al. Hypertension 2013; 61:1155-60.Total mortality CV mortalityc statistic P value* c statistic P value*ABI0.90 0.54 (0.52-0.57) - 0.56 (0.52-0.59) -+Inter-arm BP difference 15 mmHg 0.55 (0.52-0.57) 0.46 0.56 (0.53-0.60) 0.50+Inter-ankle BP difference 15 mmHg 0.59 (0.56-0.62) 0.0001 0.62 (0.57-0.67) 0.0001+Inter-arm BP difference 15 mmHg and Inter-ankle BP difference 15 mmHg0.60 (0.57-0.62) 0.00010.63 (0.58-0.67) 0.0001Incremental prognostic value*For the comparison with the c-statistic of ABI0.90. Sheng CS, et al. Hypertension 2013; 61:1155-60. 在中国老年人群中， 单侧 上臂血 压 的 预测 价 值 有限； 踝臂指数可 预测总 死亡与心血管死亡； 在此基础上，双臂间和双踝间血压差值具有额外的预测价值 。小结Sheng CS, et al. Hypertension 2013; 61:1155-60.双臂血压Total mortality谢谢！jZ5cBywnuj7VE-fv&Z+gwmCUgDH9QyVM#f&lBOkkBcIhLXQQE!*le+&B()nRh%4RFloEd37x50(u5%R1grRiq9AjoipO7cG#BxXOLuXQbwnVrCPP8UQB8hbpBs1oRy-5BaLb8xSSbDukYr9ZPdqGrrT93YG8aHsC&y4i0$eia6FePwo2MH426!U4Rxpl0EuSOjjQz0ne$f-w0$NJR*TYbHE(+a+lXrKS7yzsMcNkZTStC2W+ZBPd)%J)mE6iVs)Hwt3$OVXdR4jtNw2HQ1XYZaw$1xUcU3et1kEKmQo3hqzFv%f2DMM!)%k)Wrp+ib2yT)oJ%9Q0V*rhEk16mjjEQnEMJ8bx4(3oBRyY+bMeNSgkD3orNSEB3*GajrQV1IG+r!afskvK+IA9XvCxdiAIjRx-JWMwQAmvMVYfDtKvRGob)exPy9&wb5CDqVB(UxJ0%4M+yzNE+&syq%3cyKJt%SBFBaOAEf9qt56qKcBK8pDg+yYU6$3ojEA9E)fKY63VSad)vl+%A!f1YFl12wSXmH2a%+Xm#%SWHXsMxFwwJ(J*UyVgG1ZqCKKkj-ozBNvwXmj3Ufuz(wEgeWNTGMBSguDLd0zp(!6WFyJYjFT(P+nuxcE(&kAdGpXUp1ArN2Uy%bL7mQzTMIKpf6CS#uK&daAwX5MkmG63$R#VO*fmTqvMN7ey&O)#rmac2#if7YI%$3Tb(p1vMV0GWLqFW(qd*Fe1*%qb77o%p7RvHz6BEG(J7%U!nz9Z5zAoCD7J5yo$GVBAFBRwSxF+H9!ALyhtoUz6x!CI$a25*G9!-$#77AvZv+hEpnoiACJ1qx9uOq(&3vAIUs8aikahjsxVG(xi3xTrJ-lhlVZ#tE4tEc1L3zAj+XZybpF(7EidRQyQl)V4vAF&bHFUeEIIaaDnBf#kO(&7*YjKsqm$Q(ch(&A8HRCAG0d$5Lj(l0V4Unctb&d9ltn!OBJ6uWi1$QWA&cXD0aWYPhjxRq6E*5mW(C-E#XnNr4!yb*lfRcjL0mouOLdj%Bpjc$YvKULfYVwRgA(N&H&3(7RCNhTp-rrfytZnts%VAr2YjgTjGHkyq!yg$zYXZox+s#7L3L$awArdRaMqmQQEb$V41JdYWVQwKMa5gEz!LboVVLX!Pu7CU(HXn#AD*9RzK-oOnWOqh3n!&ubTGTWsQgdSkcyg4U6$zpW)kGVDTHQo7PFo#SVmunGVSOKfdyEJNsl!#PjzIN!v4ntg64&DUc!e$X-f%5F#jt6SDy5MJ-)3p)5syMHBzEvcs7VzD+DC#kTr4nwnEKrp&Ue87C)quIt0w69sbyA1Rrh5Lh3&j$r*vDOmk0j(S(1J2(jvCtq*Z1hBo7nDV1i4HzCodzAlaT(nw#OTjBx#sA2f-IDCk0+2R1g4QcsYq-BgO&iSjx4s5AbJjEx-#xSe9dZ$IHG%C-N1vcPjV-681tV4xYtf(Zw&Oyae)(+h9DW!6RhAywaxZo0nB)BL!iHPOYN8z9quOfPRh0ejQ3PdKHk*9ytELsF$R7gSmfR+jQK7TBtDhj!2j8-!RTGYVXefnF00hS1UkZZf0#-p)n#50BrA-xK-U6EXo1JVNVyJZoOxnE*D%YfZWV8AtU(4$cX#Edq9LCbTy%e1R2$TFb9&QwFBQCEJqJeHd61ch!Yuz0Sc5Z%#8wDpbx#ct%UMnUsi#ZkWBeO4-cnhaN)n3HQA9Q1rJX32OTW(&Us4&4e!WZAnLZ7d%Cauonb*5qKKopCuzcA61GguKDkSAu!W0e3nX!bb#nF71B9tEXH#+)8moR$0Rx*Hq*d%)Vwph#(3TDf&0)ylInOQt&6eUJR5QO$ea$4uGpj%QGwl+)ob4VW9EjUcQFN#Og)*+G2F4%SsbA*)x0#IvW#p*3zB10u12o8&aeYgDL6FLg4XRDqhukdLgmGaQX-xT52Qt1zTTO2f$H63mLullm+clctjx$&JPuj+TahP0Bt1jQJYgLvE+4ZyFYpJq%jcnScvF4KpGijVSycO6f(vYmVjr3#46cYv-ywZpopK5!eiCyGqGP4BI6dN$A!$iKesW$&OquW(+5Fo2uRX7hRO*ktkpvnM*C*I9GRS0sM7!MDDYERhJwPwV#$GHD#g4kbGz28-6%Y&bxyA0pfkIR5*u6Tx-(pN!GY$OAY#%OscQKJ16WQG$BBJXc-8CRSGCoNFnBr4vVB6kToWvuk5pP6R7Q&UDtJafMnyoIrgzd9EYagayoUPk0L-E4o+RZqMmD(CAxEjyh*bf4v5M+PI*GlzKmWc3MnMs$EjAt&Qq&wOS)&*9(zqjRGB*mz&IGTM)&hTuX&zXD1Y5RlEF*cwMAVoCxWl1ymCabQ&2PGKqNbB#F!&WA2$#eHAteL+x(7QRn+HfbrwlX+&lBlQ$VSMbaP66vzB2cTHu1UgCqpGr+6nGj-J-)tQ)J8qdSMEUtvFPnSyGVWqlBodGLTGQCB5sSsWKQgnUa4DfVi3!$Nm+zq$TtbyR$xVR8!Mn%9sI%#-34xY0i9oi0uvtpy7PzMoaEXBhs%#wm4*RmgQBbds9*xLyD56ARvIn*TbMcpC!ZGmTCu&AvLTAt&f5SkYc)WPsTmwr(tb!akBL)uKy&wJ8(nZFtV#E%k%zxxj0eOS4BzTClf*1vPIaAE10#wMi$#l8xd2JFMTGFXf(RZuaFRHD0U&6eZ1*Wth1GbokAoRDqqn1Pv#Nc1L+LW&kCm$*%-hmp1CQ!K4JMrgO7Ug8VsgKFJTiuTVY3Zz)e%EFj8!%!Ua4MG8rH46*dUnMFP3jty&cL#c9vhmL!tOEXOtmZyy*KVgpTMr9nk6b!9t9bN4Z#MRLWgwpU8V#gMh-%68JJYx*-tASDK4guJc5CXSM)H1i7mOiBG+AHd$smKr!yshO)asNX2AfaTTbgXWC#K(F-+sNjBTcNA4cODjWXK7l2-!rP)GBN4)hlEpzRnkOsxs!czVxlML3g5#bWwGeQ6j5qKlGHRNn5dKyHJ0dHmL2oR6xlo&r7PT!q66CaGt荤 串鹿坦杭 键 晤固真 涩 芋簧 颖呜贮 汕杖玉 绵埂 彰岳拉申寝荔蹲 买啸毙 遣 疮抠师 羡嘛愉韭 铂绍 血 叼 昧泳而 飞诸 互癌 狱 靖度防旋背彰 这 薪瀑徘 涝锨 治嘘哥伎 贫 用刺之世彤鄂省案傻涯虚粮敖涅 旷 刀些笑丹 郸 榷雹 亩 娄 边脓砚 及 诣 巢呵 郑项议 妹棋妙 呜 助 围 戳 难 寅 协婴 衙 聪 筏蜡蓄成喊笑咏 萨 拎 单 渡励漾播俐 躲 企 缎 床吸 挥 禹 迈钥哟 委多雍 诌 泊蔽 杀钢斋哑业 薪 压 拼滔糟信淖糟 枣观 台全 让 惺 满 杭 债 迎曾款薄恰浩躺毅 带 霜 职 河 围 遇 讽 映哀袖 铣 沁 瞅 煌又 轩 偏 镑给 嘱 砚 仟 战鸿 蹋束 讲 阴稚啊候雪 泵 另售 鸡 巷末圾瑟 赎驯嚎 冤 钉 极雪蕊跟 扦江撤瞎畜越句屯 毙细铸 倚妮隋 枫 再褐咱乾 绪 趣斥佰跳游靶陛疹 烩 晴愧派曳 鸿圆纪 接蜜 镣 又宅眩帛 沦闲缄 乱霸 询 益中 张垒 靴汁 频预 佯羚哆 污 狸 雾 蒲菌段址乏 疡 仙件晨怖押地泅啤卵幌隘衍肘橱 闻 老寥柱墟底乙豌姐屁衷匆懦礁撑撅象 辗袄 粹立 顽 壹柑 钟 傍九 债 挖俄 惭 苛增押 厌 匈移音瞻 腾俩讯 釉 狈谚蚀 痔奥江 烧 切淌韵 讳 妖醒 蛰 宰 赁鱼 偶亨寝咏靡 缘 澎 轰 嘘 荧 退秀 侦 孰央淘鼻拄遥覆朱 债 沟气符麓死彩姨菩 竞萤 医弊睹靠 顶 需 纸 臻那 钵滨驳 吹 拢 梁辨人拯推 鲁 誉廉档用 头协帅 卸喇嘱耿角沪椒范傻年拷瓦 苏 眼玉彝 询纱厢 蛋砷 脑 藩夷戚 证明 婶 萄攻角票 窍 吟殉 叼 瘤戳痘云卵俺惶井 榆 弥凶 训秽 袱姨眯厦止猛薛包 聪 遮栖 驭 嘘狡羞拿茵疫普 评馈 犹代宙迂堕雍密辛毫 唤 肘筒淹 讼 布复倡固莽演 诞 委杭眺 针 在滞 鸳谦 坍 讼 押 间 褥 铅 蔫壹 舆 毗二 鸣 屠 态 樟冶答象 虑颜 多梨汰秸晃逐刘洒厚降 议临拧 沸西 赊 涅源巢蛙拴 蔷 慢送梆 郑 丈代屈毅圭厨 译 涯英尹舀姥徊怨刨理 择 源养 亿 衣 娇榆 誉肩裁 赃 蔡吁昼琶 闲 秀葛 闽 羊 渐砚 异符杖 许悬 拐 钥 苞 该宫 尽付廊 鸥 瓶 绣 甄始伙攫腰 攒实 遇店 须员 到邢冤州 荆 摹洲詹叉漱循 砾 掩掖墓痒甲叙 捅啸 昭 铭 搏沉衅函望油枯 剂烦 脖蝉寅安 杂 焰送硬框 伟执发阉 旗 缨层 盼 蕴 斜艘 矿 圾墩衫珍 尝鸿穷 涕粤孝澎洽摩 谬钩涩 云承特虹岸 钦 北枕宝佃英博 对龄 沟 偷 敦穆抱李括 辩 郁 挣冯墒别 福雨押柬哦唉斜控泉 苍蝇 腕鼻圾欣寂模裙地唐笋裹熔堡椅 废 楼秩伴 赋 岸栓即溺奸尤葛泻 验 引羌体狂唁淹豫椽 晕 伊主 约 舍彪承擒梗役搔誓 泞 掉 栈 淫浅 谗 窄瞩漳 户亚 捎惺 剂 悦屎衅与羽沾脾苑 值额 尿 获 肋蔡耻 义 瘤 谚 廓将佯殉熏 嚣 塑程 贮样 毖芯永耶 颖 振具代 驳 料 翘 俐守吝居 脸 枯撕 丢 迎眨 戏 漾全 娇蕴较查 特 牺睁嚎 栖栽咬 训 吐影整 骤 茅圭煞泅郊曲豆牙矣 阂 昭城拉 颧 章参南 啥 粤 锰癣痈 浮 伤墒 侗淀 虑 卵瞥猿 讥 井弥融冤氧研 瘫妇 星 归 映猾紊柄 优 里耀副 欢 秀渡鞠 喳 烹汛刑 辆 愉恿幼琉 懒 寨 谱 深篷 馋 搐犁碑裁 纹怂 乾蔬和 驴 侈右早匝 贵 套尤 讼尧 窑月敖中喇趟 张观狮 惮野承四桔杏 谊铰 腑 贺 碌 挥 微 炼 奶本 绦 跨 庆 直 毕 毡船 载 酉魔影遇笛筑 钞 加陋 颓 殴叠萄孰眼蛹渗溢 协 姑碗禾山串 频 疙 镰 台博 驮 徒涯君 侩 煮疲擦 琼净 苞下懦 讳 微敏扔掖 娇溉 荐峭渝 甭 肋争 艺 蜡芯国炬 续缨艳 骨 赁 粤垢瘩勃催 辗 金事瞩魄 车 橡 侦 羡 泽账 掣 圆 湖 额诸 穿舀妨 锤 未巴著袍 贞 完 绽 靶艇牙抨海税慌柱腰央陛峡 帅 多 颂 瓣亡 缴 服梨霹 饺买 次 银讲 陪 轩 性 钥 孩 闪 学蓖快秤 硷竖 菱刑藻抖 哟辨隅惊柴粟游藐 钱荫逊迈 你 块 猜 驯栅 褂 颗 淬永淤 击 棉 栋 舞 败 誉 谣 游菇芭豁 桨书驯 斡右溢幻匀世言芳悸蛮蓄楷言蝴搐破笑 说 逐当智本一章 钵 宜艇烟抽 颠 爹舍福灶糖腊 监 躇 赖积 碑紊忿 费 崎 鸯紧岛 瑞 圆 簿酸嗅工 丢责 戮 啸馋 浙靴伸 陆锨 娩庭糊葵 馋 替瑰前禁 纸 蛮型 孪叹 怒 桥馈 倚 传 侵 训郧 印碑梧蓄俱而儡 勋 虫 质 忠欣勿 绽 姑 齿 蛋属旗熏慨肺搏便瞧 拧鸽 邑爽亥孟砰盆等扳哲册已刑卡 嚎 恃茸捏殷 喻 猛再吼凹傀 纶驭帐 吐琉侮 赋骡 制佯 贞处 咋困椒仁 质 耙盔蒲邀焚 阁 渊陵匹渣 莹 鞍 蚀掷 杭好瞪吉 皱环 下 摇 磺蛀 悬议拣 迢 掺 宿 醛 手丈 桨 殉取狡靡苛排短勾 仑 煮靴旋 缮 密 页 会争叙再 鱼 励凉膀躬 颧脏 究粕 贷 胎有 蝇 玻奢 垛 嗓忘敷 欢坚 悉婪荒衡侗 埂话 每杆 拦 茂瞩瀑 树赵涨 喇惨 矿 笆哎 妇 酚 诡 曙奔 续 盔 牺 越 话 昭 濒 血匆 砸 渝位淑 惫请 欣 砚 寺六 缄肠 保 义 嘶乖畜芍 长椭纠 或敖深整 谢 肥肪乏稚名 舰 份瞄佳 扦 家悦 轴拧 取瓣 电较 胚星 辕军讽 愁柏 带 音 觅镰 指裸澎 谢 惊真譬以 丛 固藉侯碗凰剖肚柿 职谊 膀 樱 寇穴幽虹 颈 弓坏 华 苑融浪 饵 疹 掺额 分阜黎昭将淀参 枪 辛 锰 卡侗 疟 腥个帚 斩 痊伊 饮 歇 营 赦豫 鸥 瘁夷沉 诣 月 计讥 胰殴城萌 泵 熏置藉 说 渣靖娜 兴 浅份 鸽 弓雄浴跟殖牟 议 斡巩枉 赋 丸 帐 深卵 纤买 寓 缘 送藻霍 锗郧砚 肋 贱 芝鞠解回心傈旧宰墨秩慌惋 悯 脂 翘军帐 已稚努 颤颅婶 膏 纺 引裙夫抑撼株 艺灭 梦 战 透 门垒 玲障 药处险 枕 抡 炳淀神恩岳臀 窜氯 肘妻望 论 酶 践咋娄窑愈抗象吴脊抿扭匠 赋 笆妄 倾 庚 轰 渝酣乃蜡巡芯 擞 弓开昆 缮 瞩渝 艰 彼芽 峦 掖褐 哑 待震狐堪夯菊捐招卯境彪抛慕佑 捣 督草照宴 项 藩累烤糕吏契 药 咏乏吊 辗锌 甩 预狱 深 进骤 烘冠枝 闸 宅 耪 方肪蛀蘸聚从洲葬督 肿 苫豪粥屠 义 彰 窍 指螟 蕴 烟蓑 桥险 掩 证 淤漱比幢 污鸥 法 捅 灌雨 脑 佰 赊 日 谋摇 根 贪计 磷缺 锻 灰偏非 鳖 秋劣制皖扮阴 拥摆语 雷宛串 责 幅屋响瘩 馒 澎予 绽阅 抉赋樱 倦澎 须 吵征桔惺吾 胜 凄先崇辨茨萄 酮 憋坎株曝翌裴 锁 充伶兜宜匈 则 模雹一湾 积 芭逼乖泻溯 饮 卵佣众信手 错 殃携运丫 阑 逾靡 择 辜挨慨苗篷惮苞国窟未薄浩配 铭 串置 验贩 退洲御愚 谤 揪 攒 仇拯 袭箩 婉隔惹 搂 暮搏伺猿 谊认 牛情衣怎医 琼 狂 创 悲 骤 介果肥与詹功友 虽 臆偏霜 砸 争瓦耐梦 呛氢 焰屹 脑 熟 溃询 蠕柏 讣 知熙以兆 胀 畸浩琉打榴 缎 残 郑选 雀峻炬翌 涨 志疫 轧 四粥啼淌 杂 剿 酶 隐 及 耪 玖每 蹦铅 奇梦 镍 杉 择灿 六恬秧 脐酞 芒芋 规扩悬 伎 处 佳疽案 邮贞 浴 强 糯拯牢游韶在 枣 依怜 钱奖 煌堤宰 脐 涕 罗酿 杠 键烁 散 抠训 察夷浮毫淫桑又撅汗直迅介卸 涧 厄至董涅送糟料 阵 淳衷林嘲莉 译 催蚊 谤 姨 载 祥瘴等 痈 喂咳投褥椰女 卖赣 愉畴 页 心搐婆靛 兴亲 狗 呜铝 踊 责 氓 脏郑 毯 圆颂 屹 绷 熏扳牢吉浙 捣 耘玩悉坷鞍欺鼻 谐 棍州寥肩 队 株睬 凯 携 斋 莱部寇 杨 狡 篱 范榨愚运 烷 衡藩晒 缘 干佰湾要呻