增龄与动脉粥样硬化性心血管疾病临床类型的相关性分析

Relationship between aging and comorbid clinical classifications of atherosclerotic cardiovascular disease

目的:探讨增龄与动脉粥样硬化性心血管疾病(ASCVD)临床类型及其他心血管病危险因素的相关性。方法:连续入选重庆医科大学附属第二医院老年心血管科2016-07-2017-07入院患者1 014例。根据ASCVD临床类型将患者分为3组:A组:非ASCVD组(130例);B组:ASCVD单一临床类型组(334例),包括缺血性卒中126例、冠心病154例、外周动脉疾病(PAD)54例;C组:ASCVD多种临床类型并发组(550例),包括缺血性卒中合并冠心病147例、缺血性卒中合并PAD 116例、冠心病合并PAD 145例、卒中合并PAD及冠心病142例。比较各组间临床指标的差异,并通过多因素Logistic回归模型探索ASCVD多种临床类型并发的危险因素,进一步采用相关分析研究增龄与其他ASCVD危险因素的相关性。结果:C组患者的年龄较B组升高[(76.49±8.07)岁∶(70.20±9.02)岁,P<0.01]。多因素二元Logistic回归分析校正心血管病常见危险因素后提示:增龄(OR=1.059,95%CI:1.038～1.080)、颈总动脉内膜-中层厚度(cIMT)(OR=15.177,95%CI:4.369～52.723)、吸烟(OR=2.472,95%CI:1.709～3.576)、糖尿病(OR=1.890,95%CI:1.273～2.806)、血清肌酐(Cr)(OR=1.028,95%CI:1.019～1.037)、脉压差(PP)(OR=1.029,95%CI:1.011～1.048)均与ASCVD多种临床类型的合并发生独立相关。双变量Spearman相关分析及偏相关分析结果显示,增龄与cIMT、Cr、PP呈显著正相关性(均P<0.01)。结论:增龄与cIMT、Cr、PP对ASCVD多种临床类型的并发具有协同作用。随着年龄的增长,ASCVD多种临床类型并发的风险增加,需及早开始监测相关风险指标。

Objective：To explore the relationship between the increasement of age and clinical classifications of atherosclerotic cardiovascular disease（ASCVD）and other cardiovascular risk factors.Method：A total of 1 014 patients admitted in our hospital from 2016-07 to 2017-07 were enrolled.According to the clinic classification of ASCVD,all patients were divided into 3 groups：Group A（n=130）,patients without ASCVD;Group B（n=334）,patients with one of the following disease：stroke,coronary artery disease（CAD）or peripheral artery disease（PAD）;Group C（n=550）,patients with ischemia stroke＋CAD,stroke＋PAD,CAD＋PAD or stroke＋CAD＋PAD.Firstly,the baseline clinical data among 3 groups were compared.Then,risk factors for multiple clinic classifications of ASCVD were explored by binary Logistic regression analysis.Besides,the correlation between age and other risk factors were analyzed.Result：Patients in group C were older than those in group B [（76.49±8.07）years vs（70.20±9.02）years,P〈0.01].Multivariate Logistic regression analysis suggested that ageing（OR=1.059,95%CI：1.038-1.080）,cIMT（OR=15.177,95%CI：4.369～52.723）,smoking（OR=2.472,95%CI：1.709-3.576）,diabetes（OR=1.890,95%CI：1.273-2.806）,Cr（OR=1.028,95%CI：1.019-1.037）,and PP（OR=1.029,95%CI：1.011-1.048）were independently associated with multiple clinical classifications of ASCVD.Bivariate Spearman correlation analysis and partial correlation analysis showed that ageing was significantly positively correlated with cIMT,Cr,and PP（all P〈0.01）.Conclusion：Age,cIMT,Cr and PP have synergistic effects on the development of multiple clinical classifications of ASCVD.The risk of comorbid clinical classifications of ASCVD increases with age.It is necessary to start monitoring relevant risk indicators as early as possible.