中国35-64岁人群白细胞计数与心血管病发病危险的前瞻性研究  

The association between white blood cell count and lO-year cardiovascular risk in a large Chinese cohort aged 35 - 64 years

作　　者：刘群[1] 赵冬[1] 王薇[1] 刘静[1] 孙佳艺[1] 刘军[1] 秦兰萍[1] 吴兆苏[1] 

机构地区：[1]首都医科大学附属北京安贞医院北京心肺血管研究所流行病研究室,北京100029

出　　处：《中华心血管病杂志》2008年第5期453-457,共5页Chinese Journal of Cardiology

基　　金：基金项目：“八五”国家科技攻关课题（85-915-01-02）;北京心血管病高技术实验室资助项目（953850700）;国家“十一五”科技支撑计划项目一部分（2006BA101A01）

摘　　要：目的探讨我国35-64岁人群白细胞计数水平与不同类型心血管病（包括急性冠心病事件和急性脑卒中事件）发病危险的关系。方法采用前瞻性队列研究的方法，对1992年建立的11省市35-64岁队列人群共21318人的基线白细胞计数水平和1992-2003年发生的急性冠心病事件和急性脑卒中事件的关系进行分析。应用Cox比例风险模型对白细胞计数水平与心血管病发病危险进行多因素分析。结果（1）白细胞计数从参照组4.0-4.9×10^9／L开始，随着白细胞计数水平的升高，缺血性心血管病事件及总心血管病事件累计人年发病率呈持续上升的变化，缺血性心血管病事件及总心血管病事件发病危险随白细胞计数的升高而增加。（2）白细胞计数水平与不同类型的心血管病发病危险的关系有所差别：与参照组（4.0-4.9×10^9／L）相比，随着白细胞计数的升高，急性冠心病事件发病危险及缺血性脑卒中事件发病危险上升；而出血性脑卒中事件与白细胞计数水平未见明显相关趋势。（3）多因素分析显示，当白细胞计数〉9.0×10^9／L时，总缺血性心血管病事件发病危险增加（95％ CI：1.188-2.416），其RR是对照组的1.7倍。结论随着白细胞计数的升高，缺血性心血管病事件及总心血管病事件发病危险呈上升变化。Objective To evaluate the association between white blood cell count and the risk of cardiovascular diseases （CVD） in subjects aged 35 - 64 years. Methods This prospective study was carried out in 11 provinces from 1992 to 2003. The association of baseline white blood cell count and cardiovascular disease occurrence was analyzed in 30 384 subjects aged 35-64 years using Cox multivariate proportional hazards regression. Results（1） Compared with the group of 4.0-4.9×10^9/L, multivariate-adjusted relative risk of ischemic cardiovascular disease（ ICVD, including coronary heart disease and ischemic stroke） increased continuously in proportion to increased white blood cell count. （2） White blood cell count had different impact on different types of CVD. Positive association was observed between white blood cell count and the risk of ischemic stroke, but the relationship between white blood cell count and the risk of hemorrhagic stroke was not significant. Compared with the referent group （4.0-4.9 ×10^9/L） , the risk of coronary heart disease of the group of white blood count 〉9.0×10^9/L increased by 70% （RR = 1.71, P 〈 0.05 ） and that of ischemic stroke increased by 80% （ RR = 1.85, P 〈 0.01 ）. Conclusion The risk of ICVD and CVD increases continuously in proportion to increased white blood cell count, the white blood cell count mie..ht be used to predict future risk of CVD, especially risk for ICVD.

关 键 词：冠状动脉疾病 脑血管意外 白细胞计数 前瞻性研究 

分 类 号：R686[医药卫生—骨科学]