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过刊目录

2019 年第 10 期 第 14 卷

中老年体检人群颈动脉粥样硬化影响因素分析

Analysis on contributory factors of carotid artery atherosclerosis in middle-aged and old people undergoing physical examination

作者:于汶胡荣薛源孙佳艺

英文作者:

单位:100029首都医科大学附属北京安贞医院健康体检中心北京市心肺血管疾病研究所

英文单位:

关键词:颈动脉粥样硬化;影响因素

英文关键词:

  • 摘要:
  • 【摘要】目的    了解中老年体检人群颈动脉粥样硬化(CAS)情况及其影响因素。方法    采用横断面研究方法,选取2014年1月至2017年12月首都医科大学附属北京安贞医院45~75岁中老年体检者948人,均进行颈动脉超声和血生化检查,同时收集既往史、生活方式等基础信息。结果    本组经颈动脉超声检查存在CAS病变者为662例,总检出率为69.8%(662/948)。组间比较显示,CAS组年龄、男性、高血压、吸烟、过度饮酒、缺乏身体活动、膳食结构失衡比例以及血清同型半胱氨酸水平均明显高于正常组[(60±7)岁比(53±6)岁、61.3%(406/662)比48.6%(139/286)、80.1%(530/662)比39.5%(113/286)、33.8%(224/662)比12.9%(37/286)、32.3%(214/662)比14.3%(41/286)、56.9%(377/662)比35.3%(101/286)、61.2%(405/662)比25.9%(74/286)、(19±6)μmol/L比(14±4)μmol/L],差异均有统计学意义(均P<0.05)。60~75岁体检者CAS检出率高于45~59岁体检者[78.0%(333/427)比63.1%(329/521)](P<0.001)。男性CAS检出率高于女性[74.5%(406/545)比63.5%(256/403)](P<0.001)。Logistic回归分析显示,年龄(比值比=1.076,95%置信区间:1.064~1.102,P<0.001)、性别(比值比=1.714,95%置信区间:1.081~2.695,P=0.024)、高血压(比值比=1.453,95%置信区间:1.024~2.315,P<0.001)、吸烟(比值比=2.135,95%置信区间:1.281~4.143,P=0.018)、过度饮酒(比值比=1.564,95%置信区间:1.157~3.168,P=0.021)、缺乏身体活动(比值比=1.466,95%置信区间:1.047~2.154,P=0.032)、膳食结构失衡(比值比=2.015,95%置信区间:1.562~3.473,P<0.001)和血清同型半胱氨酸水平(比值比=0.423,95%置信区间:0.237~0.651,P=0.004)是中老年体检人群发生CAS的影响因素。结论    中老年体检人群随年龄增长,颈动脉粥样硬化发生率逐渐增加,且男性高于女性。此外,生活习惯等许多可干预的因素会影响CAS的发生和发展,加强健康管理对CAS的防控具有重要意义。

  • 【Abstract】Objective    To investigate the influencing factors of carotid artery atherosclerosis(CAS) in middle-aged and old people undergoing physical examination. Methods    A cross-sectional study was performed on 948 middle-aged and old residents(45-75 years old) who had physical examination in Beijing Anzhen Hospital, Capital Medical University from January 2014 to December 2017. All subjects had carotid ultrasound and blood biochemical test. Previous medical history and lifestyle characteristics were analyzed. Results    The detection rate of CAS was 69.8%(662/948). Age, rates of male, hypertension, smoking, excessive alcohol consumption, lack of physical activity, dietary imbalance and serum homocysteine level in CAS group were significantly higher than those in normal group[(60±7)years vs (53±6)years, 61.3%(406/662) vs 48.6%(139/286), 80.1%(530/662) vs 39.5%(113/286), 33.8%(224/662) vs 12.9%(37/286), 32.3%(214/662) vs 14.3%(41/286), 56.9%(377/662) vs 35.3%(101/286), 61.2%(405/662) vs 25.9%(74/286), (19±6)μmol/L vs (14±4)μmol/L](all P<0.05). The detection rate of CAS in 60-75 years old people was higher than that in 45-59 years old people[78.0%(333/427) vs 63.1%(329/521)](P<0.001). The detection rate of CAS in males was higher than that in females[74.5%(406/545) vs 63.5%(256/403)](P<0.001). Logistic regression analysis showed that age(odds ratio=1.076, 95% confidence interval: 1.064-1.102, P<0.001), gender(odds ratio=1.714, 95% confidence interval: 1.081-2.695, P=0.024), hypertension(odds ratio=1.453, 95% confidence interval: 1.024-2.315, P<0.001), smoking(odds ratio=2.135, 95% confidence interval: 1.281-4.143, P=0.018), excessive alcohol consumption(odds ratio=1.564, 95% confidence interval: 1.157-3.168, P=0.021), lack of physical activity(odds ratio=1.466, 95% confidence interval: 1.047-2.154, P=0.032), dietary imbalance(odds ratio=2.015, 95% confidence interval: 1.562-3.473, P<0.001) and serum homocysteine level(odds ratio=0.423, 95% confidence interval: 0.237-0.651, P=0.004) were influencing factors of CAS in middle-aged and old people. Conclusions    Incidence of CAS is associated with age and male gender in middle-aged and old people. In addition, many controllable factors such as unhealthy lifestyle and habits may affect the occurrence and development of CAS. Strengthening health management is of great significance to the prevention and control of CAS.

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