中年体检者心血管病发病危险的评估与分析

Risk assessment and analysis of cardiovascular disease in middle-aged volunteers

目的 探讨“国人缺血性心血管病十年发病危险评估方法”在中年体检者中的应用价值.方法 应用“国人缺血性心血管病十年发病危险评估方法”对1203名35～59岁健康体检者心血管病10年发病的绝对危险和相对危险进行评估和相关分析.结果 （1）中年体检者10年缺血性心血管病发病的绝对危险均值为1.30％±1.80％,其中绝对危险≥5％的45名（3.7％）;（2）中年体检者缺血性心血管病相关危险因素（收缩压≥140 mm Hg、舒张压≥90 mm Hg、体质指数≥24 kg/m2、总胆固醇≥5.2 mmol/L、空腹血糖≥7.0 mmol/L、吸烟）的检出率男性高于女性,差异均有统计学意义（x2=26.942,P＜0.01;x2=29.250,P＜ 0.01;x2=233.325,P＜ 0.01;x2=5.510,P=0.022;x2=5.730,P=0.015;x2=65.009,P＜0.01）;（3）10年缺血性心血管病发病的绝对危险≥5％的人群各项心血管危险因素的检出率均高于发病绝对危险＜5％的人群,差异均有统计学意义（x2=239.62,P＜0.01;x2=10.78,P＜0.01;x2 =36.40,P＜0.01;x2 =35.19,P＜0.01;x2 =25.42,P＜0.01;x2 =4.98,P=0.034）;（4）不同年龄组10年缺血性心血管病发病相对危险在平均水平倍数≤1和＞1间、理想水平倍数≤1和＞1间比较,差异均有统计学意义（x2 =52.032、160.077,均为P＜0.01）.结论 “国人缺血性心血管病十年发病危险评估方法”已成为评估我国居民心血管病发病危险的重要工具.10年缺血性心血管病发病的绝对危险在公共卫生领域有重要指导意义,而相对危险对个体的临床综合干预更具指导意义.

Objective To investigate the clinical value of Risk Assessment Tool for Estimating l0-year Risk of Having an ischemic cardiovascular disease （ICVD） in middle-aged volunteers.Methods A total of 1203 healthy volunteers aged from 35 to 59 that satisfied the recruit standards were collected.The absolute and relative 10-year risks of ICVD were estimated and their relationships were analyzed.Results （1） The average of absolute 10-year risks of ICVD in the middle-aged volunteers was 1.30% ± 1.80% and the number of the absolute 10-year risks of ICVD≥5% was 45 （3.7%）,respectively.（2） The detection rates of ICVD risk factors of middle-aged males were significantly higher than those of females,which included systolic pressure ≥ 140 mm Hg （x2 =26.942,P 〈 0.01）,diastolic pressure ≥ 90 mm Hg （x2 =29.250,P 〈 0.01）,body mass index ≥ 24 kg/m2 （x2 =233.325,P 〈 0.01）,total cholesterol ≥ 5.2 mmol/L （x2 =5.510,P =0.022）,fasting blood glucose ≥7.0 mmol/L （x2 =5.730,P =0.015） and smoking （x2 =65.009,P 〈 0.01）.（3） The detection rates of ICVD risk factors in those whose absolute 10-year risks of ICVD higher than 5% were significantly higher than those absolute 10-year risks of ICVD lower than 5% （x2 =239.62,P〈0.01;x2 =10.78,P〈0.01;x2 =36.40,P〈0.01;x2 =35.19,P〈0.01;x2 =25.42,P 〈 0.01 ; x2 =4.98,P =0.034）.（4） The relative 10-year risks of ICVD between average level ratio ≤ 1 and 〉 1 in different age groups was significantly different （x2 =52.032,P 〈 0.01）,the significant difference also existed between ideal level ratio ≤ 1 and 〉 1 （x2 =160.077,P 〈 0.01）.Conclusions The risk assessment tool for estimating l0-year risk of having an ICVD is an important method to assess the risk level of ICVD.The absolute 10-year risk of having an ICVD is meaningful in public health while the relative 10-year risk more useful in clinical treatment for individual.