社区高龄人群动脉粥样硬化性心血管疾病影响因素的相关性分析

Correlation analysis of influencing factors of atherosclerotic cardiovascular disease in the elderly in the community

目的:分析高龄人群(≥75岁)发生动脉粥样硬化性心血管疾病(ASCVD)事件的危险因素,为指导全科医生对社区中有ASCVD患病高风险的高龄人群进行早期干预提供理论依据。方法:选取2018年1月至2021年3月期间在江阴市城南、城中以及华士社区卫生服务中心门诊就诊的高龄人群作为研究对象,共入选319例。采用二元Logistic逐步回归分析探究社区高龄人群的ASCVD风险的影响因素。结果:对照组98例,病例组221例,病例组中年龄、婚姻状况、睡眠质量情况、体力活动情况、失能情况、是否痴呆、颈动脉超声评分、血压控制水平、家族史、合并高血压、收缩压、总胆固醇、共病指数、服用药物数量与对照组比较差异有统计学意义(P<0.05)。病例组中性别、吸烟史、饮酒史、合并糖尿病、体重指数、舒张压、高密度脂蛋白、低密度脂蛋白、甘油三酯、空腹血糖、糖化血红蛋白、尿酸、肌酐、尿素氮与对照组比较差异无统计学意义(P>0.05)。经Logistic回归分析结果显示,血压控制水平、颈动脉超声评分、共病指数、服用药物数量是社区高龄人群ASCVD风险的影响因素(P<0.05)。结论:血压控制水平、共病指数、服用药物数量是高龄人群ASCVD发病的影响因素,也是相对可控因素,社区全科医生应加强对血压控制不达标、合并多种疾病、服用药物多的高龄人群进行ASCVD风险评估。

Objective:To analyze the risk factors of atherosclerotic cardiovascular disease(ASCVD)events in the elderly(≥75 years),and provide a theoretical basis for guiding general practitioners to early intervention in the community with the elderly at high risk of ASCVD.Methods:A total of 319 cases were selected as the research objects of the elderly who visited the outpatient clinics of Jiangyin City's Chengnan,Chengzhong and Huashi Community Health Service Center from January 2018 to March 2021.Binary Logistic stepwise regression analysis was used to explore the influencing factors of ASCVD risk in the elderly in the community.Results:There were 98 cases in the control group and 221 cases in the case group.In the case group,age,marital status,sleep quality,physical activity,disability,dementia,carotid ultrasound score,blood pressure control level,family history,combined hypertension,systolic blood pressure,total cholesterol,comorbidity index,excessive medication were different from those in the control group(P<0.05).Compared with the control group,the gender,smoking history,a history of drinking,combined with diabetes,body mass index,diastolic blood pressure,high-density lipoprotein,low density lipoprotein,triglyceride,fasting blood-glucose,glycated hemoglobin,uric acid,creatinine,urea nitrogen in the case group had no significant differences(P>0.05).Logistic regression analysis showed that blood pressure control level,carotid ultrasound score,comorbidity index,and excessive medication were the influencing factors for ASCVD risk in the elderly in the community(P<0.05).Conclusion:Blood pressure control level,comorbidity index,and excessive medication are the influencing factors and relatively controllable factors for the incidence of ASCVD in the elderly population.Community general practitioners should strengthen ASCVD risk assessment for elderly population with substandard blood pressure control,multiple diseases,and excessive medication.