北京社区居民打鼾与颈动脉粥样硬化关系的调查研究

A survey of the relation between snoring and carotid atherosclerosis

目的调查并探讨打鼾与颈动脉粥样硬化的关系。方法采取整群抽样的方法选取北京市的1个社区,在该社区中采取按年龄和性别分层随机抽样的方法,抽取1 245名年龄在50～79岁的社区居民,通过问卷调查打鼾情况,并测量血压、血脂、血糖等传统心血管疾病危险因素的水平,采用B型超声诊断仪检测颈动脉内膜中层厚度(intima-media thickness,IMT)和斑块的情况,对资料完整且不患有脑卒中、冠心病及其它心脏病的1 050人进行分析。结果有打鼾经历的人占调查总人群的64.3%,经常打鼾的比例为31.5%;随着打鼾频率的增加,颈动脉粥样硬化患病率有增加的趋势,经常打鼾者,IMT增厚的患病率为69.8%,颈动脉膨大部斑块的患病率为70.1%;多因素Logistic分析显示,调整传统心血管疾病危险因素后,经常打鼾者IMT增厚的患病危险为不打鼾者的1.71倍(OR=1.71,95%CI=1.22～2.39),斑块的患病危险为不打鼾者的3.63倍(OR=3.63,95%CI=2.57～5.12)。结论打鼾独立于传统心血管疾病危险因素,与颈动脉粥样硬化密切相关。

Objective The aim of this study is to investigate the association of snoring with carotid atherosclerosis. Methods We selected 1 245 residents aged 50 to 79 living in Beijing community by stratified random sampling according to age and gender. The information of snoring was obtained by questionnaire. The measurements of traditional cardiovascu- lar risk factors, including blood pressure, lipids and plasma glucose, were also collected. The carotid intima-media thick- ness and plaque were scanned by uhrasonography. A total of 1 050 subjects without stroke, coronary heart disease or other heart diseases and with complete data were brought into the analysis. Results 64. 3% of the participants had history of snoring, and the prevalence of habitual snoring was 31.5% ;The prevalent rate of carotid atherosclerosis increased with in- creasing snoring frequency. Among the habitual snorers, the prevalence of increased IMT was 69.8% and that of carotid plaque was 70. 1% ; After adjustment for traditional cardiovascular risk factors, Logistic regression analysis showed that the odds ratio of habitual snoring for increased intima-media thickness and carotid bifurcation plaque was 1.71 （ OR = 1.71 , 95% CI： 1.22-2.39） and3.63 （0R=3.63,95% CI： 2.57-5. 12）, respectively. Conclusions Snoringis closely asso- ciated significantly with carotid atherosclerosis, and is independent of traditional cardiovascular risk factors.