腹主动脉瘤与下肢动脉硬化闭塞症危险因素关联性对照研究

A matched case-control study of risk factors between abdominal aortic aneurysm and peripheral artery disease

目的探索中国人群腹主动脉瘤(AAA)与下肢动脉硬化闭塞症(PAD)两种疾病危险因素的区别与联系。方法采用1∶1个体匹配的病例对照研究设计选择2010年1月至2017年12月就诊于湘雅医院血管外科的AAA或PAD患者,每1例AAA患者匹配与其性别、年龄相符合的PAD患者。收集研究对象的一般人口学资料、既往病史和行为因素,使用标准化方法获取血清学检测结果。结果共550例研究对象275个配对组。两组在合并的高血压、高血脂、冠心病及脑梗患病率上差异无统计学意义(P>0.05),但AAA组中合并糖尿病的比例明显低于PAD组,差异有统计学意义(P<0.01);两组吸烟史和饮酒史差异无统计学意义(P>0.05);在血清学检测上,两组间血清胆固醇和低密度脂蛋白胆固醇水平差异有统计学意义(P<0.05),而尿素、肌酐、尿酸、葡萄糖、甘油三酯、高密度脂蛋白胆固醇及血红蛋白水平差异无统计学意义(P>0.05)。结论 AAA和PAD具有大多数相同的危险因素,但在糖尿病病史、血清胆固醇和低密度脂蛋白胆固醇水平上存在差异;糖尿病可能是AAA的一个保护性因素。

Objective To explore the relationships and differences of risk factors between abdominal aortic aneurysm （AAA） and peripheral artery diseases （PAD） in Chinese population. Methods Patients with AAA or PAD treated at the Department of Vascular Surgery, Xiangya hospital from January 2010 to December 2017 were selected. A 1：1 pair-matched, case-control study was conducted. Each patient who had been diagnosed with AAA matched with one PAD patient with the same gender and age. Demographic data, medical history and the lifestyle of each subject were collected. Meanwhile, peripheral venous blood samples of all the participants were obtained. Results There were 275 AAA/PAD pairs with 550 patients in total. The distribution of factors, including hypertension, hyperlipidemia, coronary heart disease and cerebral infarction between this two groups had little significant difference （P〉0.05）, whereas the proportion of diabetes in the AAA group was significantly lower than that in the PAD group, and there was significant statistic difference between the two groups （P〈0.01） in the past medical history. There were no significant statistic differences in smoking and drinking history （P〉0.05）. And in serological examination, there were significant statistic difference in the level of total cholesterol and low-density lipoprotein cholesterol （P〈0.05）, whereas the levels of blood urea nitrogen, creatinine, serum glucose, uric acid, triglycerides, high- density lipoprotein cholesterol and had no significant statistic difference （P〉0.05）. Conclusion AAA and PAD share many similar risk factors, but there are significant differences in diabetes history, total cholesterol and low-density lipoprotein cholesterol. Diabetes may be a protective factor for AAA.