心血管健康行为和因素对颈动脉粥样硬化斑块总负荷评分的影响

The impact of cardiovascular healthy behaviors and factors on total burden score of carotid plaques

目的探讨心血管健康行为和因素对颈动脉粥样硬化斑块总负荷评分(TBS)的影响。方法随机分层抽取唐山开滦(集团)有限责任公司在职及离退休职工中年龄≥40岁、既往无脑卒中、短暂性脑缺血发作、心肌梗死者共5852人为研究对象,进行统一问卷调查、血液生化及颈动脉超声检查,研究资料完整的3960人纳入统计分析。采用队列研究的方法,依据2010-2011年度体检时心血管健康行为和因素个数将总研究对象分为<2、2、3、4、5、>5个6组,观察其对2012-2013年体检时颈动脉粥样硬化斑块TBS的影响。结果随着理想健康行为和因素个数的增加,颈动脉粥样硬化斑块TBS逐渐降低(均P<0.05)。理想心血管健康行为和因素个数与颈动脉粥样硬化斑块TBS呈负相关(r=-0.19,P<0.01)。多因素线性回归分析显示,校正年龄、性别等影响因素后,每增加1个理想健康行为或因素,颈动脉粥样硬化斑块TBS平均降低0.20分(P<0.05),按性别分层后,男性与女性人群结果均与总人群结果一致,但男性人群中该趋势更明显。结论理想心血管健康行为和因素的个数越多,颈动脉斑块TBS越低。

Objective To study the impact of cardiovascular healthy behaviors and factors on total burden score （TBS）of carotid plaques. Methods After excluding previous stroke, transient ischemic attack and myocardial in- farction, a total of 5852 employees over 40 years old including being employed and retired from Tangshan Kailuan company were enrolled in this study through stratified random sampling. All data were obtained from the unified questionnaire, blood biochemistry measurement and carotid artery ultrasonography. Among enrolled employees, 3960 had complete data which was used for analysis. Based on the number of the healthy cardiovascular behaviors and factors identified during 2010-2011 physical examination, employees were divided into six groups： 〈2, 2, 3, 4, 5 and 〉 5. The impact of healthy cardiovascular behaviors and factors on the TBS of carotid plaques measured in 2012-2013 physical examination were observed. Results With the increase of the components of healthy cardiovascular behaviors and factors, the TBS of carotid plaques declined（P〈0.05）. There was a negative correlation between the number of healthy cardiovascular behaviors and factors and the TBS of carotid plaques （r= -0.19, P〈 0.01）. After adjusting for age, gender and other risk factors, multiple line regression analysis showed that with the increase of one healthy cardiovascular behaviors or factors increased, the TBS of carotid plaques averagely decreased 0.20（P〈0.05）, which was more prominent in male gender. Conclusion Healthy cardiovascular behaviors and factors could lower the TBS of carotid plaques.