上海市淞南社区中老年人群冠状动脉粥样硬化患病率CCTA调查结果及相关因素分析

The prevalence of coronary artery disease detected by CCTA and related risk factors in residents at Songnan district, Shanghai

目的 :探讨上海市宝山区淞南社区中老年人群冠状动脉病变的现况及相关因素。方法 :随机选取上海市宝山区淞南社区中,40~60岁、无冠心病临床症状的糖调节正常人群及糖尿病前期或病程低于5年的糖尿病患者,采用调查问卷收集其既往病史和生活方式等信息,测量身高、体重、腰围、血压等,并行口服75 g葡萄糖耐量试验及冠状动脉计算机断层血管造影(coronary computed tomography angiography,CCTA)检查,观察冠状动脉的病变情况,当冠状动脉管腔狭窄≥50%时定义为冠状动脉显著狭窄,当冠状动脉出现狭窄且冠状动脉钙化积分>0时定义为冠状动脉钙化,并分析其影响因素。结果:排除因移动伪影导致无法分析的图像之后,共有228名糖调节正常人群、191例糖尿病前期患者和130例糖尿病患者纳入分析,其中男性有233名(42.4%)。上海市宝山区淞南社区549名中老年社区居民的冠状动脉狭窄、冠状动脉显著狭窄和冠状动脉钙化患病率分别为51.4%、10.7%和14.8%。多元Logistic回归分析显示,年龄≥53岁和高血压显著增加了冠状动脉狭窄的发生风险;男性显著增加了冠状动脉显著狭窄的发生风险;年龄≥53岁和糖尿病显著增加了冠状动脉钙化的发生风险。结论:上海市宝山区淞南社区中老年居民的冠状动脉狭窄患病率为51.4%,男性、年龄≥53岁、高血压及糖尿病均与冠状动脉疾病发生风险的增加密切相关。

Objective： To investigate the prevalence of coronary artery disease（CAD） and related risk factors in res-idents aged 40 to 60 years at Songnan District, Shanghai. Methods： Community residents without symptoms of CAD and aged 40 to 60 years at Songnan District, Shanghai were randomly selected and categorized into normal blood glucose group, pre-diabetes group and type 2 diabetes diagnosed within 5 years group. Questionnaires was performed to collect in-formation on health status, medical history and lifestyle. Subjects received physical checkup including height, body weight,waist circumference, and blood pressure measurement, then oral glucose tolerance test and coronary computed tomography angiography（CCTA） were conducted. Significant coronary stenosis was defined as ≥50% narrowing of vessel lumen. Coronary artery calcification was defined to be present if coronary calcification score 〉0. Results： In the study population, 233（42.4%） were males. Altogether 51.4%, 10.7% and 14.8% subjects were diagnosed as having coronary stenosis, significant coronary stenosis and coronary calcification, respectively. By multivariate analyses, the presence of CAD was significantly associated with male, age ≥53 years, hypertension, and diabetes. Conclusions： The prevalence of coronary stenosis, significant coronary stenosis, and coronary calcification are 51.4%, 10.7% and 14.8% in the study population, respectively.Male, age ≥53 years, hypertension, and diabetes are independent risk factors for CAD.