无心血管风险因素中老年人群颈动脉粥样硬化及其影响因素分析

Analysis on carotid atherosclerosis and influencing factors in middle-aged and elder residents without cardiovascular risk factors

目的探讨无心血管风险因素中老年人群颈动脉粥样硬化情况及其相关危险因素,为降低心血管疾病负担提供依据。方法于2017年9月-2018年5月,采用分层、整群抽样的方法选取调查对象,对辽宁省朝阳县和凌源市≥40岁的1449名无心血管危险因素的常住居民进行问卷调查、体格检查及实验室检查。无心血管风险因素人群定义采用Adult Treatment PanelⅢ标准。应用SPSS 21.0统计软件进行χ^(2)检验、趋势χ^(2)检验和多因素logistic回归分析。结果无心血管风险因素人群中,颈动脉粥样硬化患病率为23.4%,男性(37.1%)显著高于女性(20.1%),差异有统计学意义(P<0.05)。颈动脉粥样硬化患病率随年龄增加呈明显增加趋势(趋势χ^(2)=62.068,P<0.01)。多因素logistic回归分析结果表明,年龄较大(与40~49岁组比较,50~59岁、60~69岁、70~79岁、≥80岁组的OR值分别为2.63、7.62、17.29和53.99)、男性(OR=1.87,95%CI:1.26~2.77)、高糖化血红蛋白(OR=1.90,95%CI:1.20~3.02)、高脉压差(OR=1.03,95%CI:1.01~1.05)及高密度脂蛋白胆固醇升高(OR=2.31,95%CI:1.75~3.04)与患颈动脉粥样硬化高风险相关。结论无心血管危险因素的中老年人群颈动脉粥样硬化患病率高,高年龄、男性、高糖化血红蛋白、高脉压差和升高的高密度脂蛋白胆固醇与动脉粥样硬化相关。提示在老年人、男性及糖化血红蛋白水平轻微增高的人群中,即使无心血管危险因素,也应该注意动脉粥样硬化的监测。

Objective To explore the carotid atherosclerosis(AS)and influencing factors in middle-aged and elder residents without cardiovascular risk factors,and to provide the basis for reducing the burden of cardiovascular diseases.Methods From September 2017 to May 2018,the stratified cluster random sampling method was used to select 1449 residents(≥40 years old)without cardiovascular risk factors from Chaoyang county and Lingyuan city as the subjects.The investigation was performed with ques tionnaire,physical examination and laboratory test.The Adult Treatment PanelⅢcriteria was used to define the residents without cardiovascular risk factors.Theχ^(2) test,trendχ^(2) test and multifactor logistic regression were used to analyze the data,the used software was SPSS 21.0.Results The morbidity of carotid atherosclerosis in residents without cardiovascular risk factors was 23.4%,the morbidity(37.1%)in males was significantly higher than that(20.1%)in females(P<0.05).The morbidity of carotid atherosclerosis increased with age(P<0.01).The multifactor logistic regression analysis showed that old age(as compared with 40-49 years old group,50-59,60-69,70-79,≥80 years old groups:OR values were 2.63,7.62,17.29 and 53.99),male(OR=1.87,95%CI:1.26-2.77),high HbA1C(OR=1.90,95%CI:1.20-3.02),high pulse pressure(OR=1.03,95%CI:1.01-1.05)and high-density lipoprotein cholesterol(OR=2.31,95%CI:1.75-3.04)were related to the high risk of AS.Conclusion The morbidity of carotid atherosclerosis in middle-aged and elder residents without cardiovascular risk factors was higher,old age,male,high HbA1C,high pulse pressure and high-density lipoprotein cholesterol were correlated to AS.It is suggested that in residents of elderly,male and slightly high HbA1C,although there are no cardiovascular risk factors,it should pay attention to monitor AS.