中老年人群中高敏C反应蛋白对外周动脉硬化的预测价值研究

The prediction of high-sensitivity C reactive protein for peripheral arterial sclerosis in middle-aged population

目的 探讨中老年人群中高敏C反应蛋白（high-sensitivity C reactive protein, hsCRP）对外周动脉硬化的预测价值。方法 于2009年12月在参加2006—2007年开滦集团职工健康体检的101 510名职工中，采用随机分层抽样的方法抽取5 852名作为观察队列，最终纳入符合队列标准者5 440名。本研究选取参加2012—2013年进行的健康体检的队列人群为调查对象，按照纳入标准最终选取调查对象3 978名，其中男性2 282名，女性1 696名，基线年龄为（53.80±11.14）岁。选取其流行病学调查、体格检查、实验室检测等资料进行分析。依据基线hsCRP四分位水平进行基线资料的比较，采用多元线性回归分析hsCRP与踝臂脉搏波波速（brachial-ankle pulse wave velocity, baPWV）之间的关系，并用受试者工作特征曲线（ROC曲线）下面积（AUC）评估hsCRP对外周动脉硬化的预测能力。结果 随着hsCRP增加，调查对象的基线baPWV呈增加趋势，分别为（1 445.49±300.55）、（1 494.46±307.94）、（1 547.67±320.34）、（1 621.32±342.53）cm/s，多元线性回归结果显示：年龄、经对数转换的hsCRP（lghsCRP）、收缩压、空腹血糖每增加1单位，baPWV分别增加266.47、58.00、5.02、39.79 cm/s（P值均〈0.001）；而BMI每增加1单位，baPWV下降9.52 cm/s（P=0.030）。hsCRP对外周动脉的预测能力结果显示：lghsCRP的AUC（95%CI）为0.59（0.57～0.61），低于年龄及收缩压的AUC（95%CI）[分别为0.69（0.67～0.71）、0.75（0.73～0.77）]。结论 hsCRP尚不能单独预测外周动脉硬化，联合年龄及收缩压水平有较好的预测价值。

Objective To explore the predictive value of high-sensitivity C reactive protein （hsCRP） in middle-aged population during the peripheral arteriosclerosis. Methods Random sampling method was used in the study. In 2006-2007 Kailuan Group health examination of 101 510 employees, using stratified random sampling method to select 5 852 as observational cohort included,in the final with a standard queue 5 440 in December 2009. This study selected to participate in the 2012-2013 health examination cohort as the research object, in accordance with the inclusion criteria ultimately selected survey 3 978, select the epidemiological investigation, physical examination, laboratory testing data analysis. Of the 3 978 subjects, 2 282 were male and 1 696 were female, and the baseline age was （53.80±11.14） years. According to the baseline hsCRP quartile level was divided into four groups for comparison of baseline data, using multiple linear regression analysis between hsCRP and brachial-ankle pulse wave velocity （baPWV）. Area under the receiver operating characteristic（ROC） curve （AUC） was used to evaluate the prediction of hsCRP levels in peripheral arteriosclerosis. Results With increase of hsCRP levels, the survey of baseline levels of baPWV showed increasing trend, （1 445.49±300.55）, （1 494.46±307.94）, （1 547.67±320.34）, （1 621.32±342.53） cm/s, respectively. Multiple linear regression results showed that age, by logarithmic transformation of hsCRP （lghsCRP） level, systolic blood pressure and fasting blood glucose for each additional unit, baPWV levels were increased 266.47, 58.00, 5.02, 39.79 cm/s （P〈 0.001）, and BMI for each additional unit, baPWV level decreased 9.52 cm/s （P=0.030）. The prediction of hsCRP in peripheral artery showed that lghsCRP level of AUC to 0.59 （95%CI：0.57-0.61）, lower than the age and systolic blood pressure predicted value AUC（95%CI） of 0.69 （0.67-0.71）, 0.75 （0.73-0.77）, respectively. Conclusion The hsCRP level could not predict the peripheral arteriosclerosis alone, and the combined age and systolic blood pressure level could have better predictive value.