基于TCD检测数据的慢病健康管理研究

Research on chronic disease health management based on TCD test data

目的探讨影响个体经颅多普勒超声(TCD)检出结果的因素,为防治个体颅内血管疾病和慢性非传染性疾病提供科学依据。方法采用随机整群抽样,选取2018年4月及11月内所有于成都某医院进行健康体检并接受了TCD检查的人群作为研究对象,共317人。收集所有研究对象的基本信息及健康信息,并结合研究对象的TCD检出结果进行分析。结果共213例研究对象TCD检出异常,检出率为67.2%。吸烟频率与饮酒频率不同的研究对象TCD异常检出率差异均有统计学意义(P<0.05),其中饮酒频率越高的研究对象TCD异常检出率越高。TCD检出结果正常的男性研究对象的年龄、收缩压、舒张压、血糖水平、血尿酸水平和体质指数(BMI)均低于TCD检出结果为异常的男性研究对象,且差异均具有统计学意义(P<0.05);TCD检出结果为正常的女性研究对象的年龄、收缩压、舒张压、血糖水平、血尿酸水平均低于TCD检出结果为异常的女性研究对象,且差异均具有统计学意义(P<0.05)。多因素Logistic回归分析结果发现,对于男性、女性而言,血糖均是TCD检出异常的危险因素(P<0.05)。结论 TCD检查能够准确反映颅内动脉硬化等导致的血流动力学变化,能够有助于识别糖尿病和高血压高危人群,且能够对糖尿病和高血压患者的脑血管病变进行预测。

Objective To explore the factors affecting the results of transcranial Doppler(TCD)ultrasonography in individuals,and to provide scientific basis for prevention and treatment of intracranial vascular abnormalities and chronic non-infectious diseases in individuals.Methods Random cluster sampling was used to select 317 patients who had undergone a health checkup and received a TCD test in a hospital in Chengdu in April and November 2018.The basic information and health information of all subjects were collected and analyzed with reference to their TCD results.Results Two hundred and thirteen cases had abnormal TCD results,and the detection rate was 67.2%.The difference in the detection rate of TCD abnormalities between subjects with different smoking frequency and drinking frequency was statistically significant(P<0.05).The higher the frequency of drinking,the higher the detection rate of TCD abnormalities among the subjects.The age,systolic blood pressure,diastolic blood pressure,blood glucose level,blood uric acid level,and body mass index(BMI)of male subjects with normal TCD results were lower than those with abnormal TCD results,and the differences were statistically significant(P<0.05);the age,systolic blood pressure,diastolic blood pressure,blood glucose level,and blood uric acid level of female subjects with normal TCD results were lower than those with abnormal TCD results,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis found that for both male and female subjects,blood glucose level was a risk factor for abnormal TCD results(P<0.05).Conclusion TCD test can accurately reflect the hemodynamic changes caused by intracranial arteriosclerosis,etc,help identify individuals at high risk for diabetes and hypertension,and predict the occurrence of cerebrovascular disease in patients with diabetes and hypertension.