Zhongguo cuzhong zazhi (Jul 2018)
理想心血管健康指标与颈动脉粥样硬化的关系研究 Association between Ideal Cardiovascular Health Index and Carotid Arthrosclerosis
Abstract
目的 通过对大型社区体检人群的筛查，调查理想心血管健康指标对颈动脉内中膜异常增厚的影 响，为颈动脉疾病及心脑血管病的预防提供证据。 方法 选择参与2015年度国家脑卒中高危人群筛查和干预项目的北京北七家社区服务中心筛查点 40岁以上无卒中病史人群，收集受试者身高、体重、吸烟史等一般临床资料及基线血压、血糖、血脂 水平，同时计算受试者理想心血管健康指标符合数目。所有受试者完善颈部血管超声，记录受试者 颈动脉内中膜厚度，将患者分为颈动脉内中膜异常增厚组和正常组，通过Logistic回归分析两组之间一 般临床资料及理想心血管健康指标对颈动脉内中膜增厚的影响。 结果 共入组4387例受试者，颈动脉内中膜增厚组654例，正常组3733例。与正常组相比，颈动脉 内中膜异常增厚组年龄较高[62（56，69）岁 vs 58（52，64）岁，P <0.001]，吸烟比例高（23.8% vs 14.4%，P <0.001）；女性（50.5% vs 69.2%，P <0.001）、理想血压（15.7% vs 22.0%，P <0.001）和理 想血糖（52.6% vs 65.7%，P <0.001）比例较低。多因素Logistic回归分析显示，颈动脉内中膜异常增厚 组理想心血管健康指标数低于正常组，在校正了性别、年龄后，该差异仍然存在[比值比（odds ratio， OR）0.82，95%可信区间（confidence interval，CI）0.68～0.98，P =0.029]。 结论 颈动脉内中膜异常增厚患者理想心血管健康因素的指标数低于无颈动脉内膜增厚者，是颈动 脉内中膜异常增厚的保护因素。 Abstract: Objective To investigate the influence of ideal cardiovascular health (ICVH) index on carotid intima-media thickness (CIMT), so as to find a new direction for the primary prevention of carotid and cardiovascular diseases, through physical examination screening in large community. Methods Those who participated in the 2015 National Stroke Screening and Intervention Program in Beiqijia Community Service Center and met the criteria of aged above 40 years old and without history of stroke were selected. The participants’ general clinical data including height, weight, history of smoke and medical diseases, etc, and their baseline blood pressure, fast glucose, lipid levels and CIMT were collected. The number of ICVH indexes in every one was recorded. The participants were divided into CIMT abnormal and normal group. The ICVH index number of everyone was calculated. The complete carotid vascular ultrasound and CIMT were recorded. Logistic regression analysis were used to analyze the the basic characteristics between two groups, and the influence of general clinical data and ICVH index of two groups on CIMT. Results A total of 4387 subjects were enrolled in our study, with 654 in CIMT abnormal group and 3733 in CIMT normal group. In CIMT abnormal group, older age [62 (56, 69) vs 58 (52, 64), P <0.001] and smoking (23.8% vs 14.4%, P <0.001) were higher than CIMT normal group; and female (50.5% vs 69.2%, P <0.001), ideal blood pressure (15.7% vs 22.0%, P <0.001) and ideal glucose (52.6% vs 65.7%, P <0.001) were lower than CIMT normal group. In the multifactors logistic analysis, ICVH index number was obviously lower in CIMT abnormal group. After adjusting the gender and age, the difference still existed [odds ratio (OR) 0.82, 95% confidence interval (CI) 0.68-0.98, P =0.029]. Conclusion The ICVH index number is lower in CIMT abnormal group than that of CIMT normal group, which is the protective factor for CIMT.
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