北京社区居民不同年龄组冠心病主要危险因素流行特点  

Epidemiologic characteristics of major risk factors of coronary heart disease in residents from Beijing communities in different age groups

作　　者：王家宏[1] 胡大一[1] 傅媛媛[2] 孙艺红[1] 王桂莲[1] 管绯[1] 余金明[2] 王劲松[2] 

机构地区：[1]北京大学人民医院心脏中心,100044 [2]同济大学医学院公共卫生教研室

出　　处：《中华医学杂志》2010年第8期529-534,共6页National Medical Journal of China

基　　金：北京市科委科技攻关项目（D0906002040191）

摘　　要：目的调查北京市社区居民不同年龄水平冠心病（CHD）主要危险因素异常的流行病学特征，探讨北京市防治CHD的方向。方法于2007年6月至2007年8月期间，分层整群随机抽样调查北京市社区居民10054名，根据年龄分为3个组，20～44岁组、45—59岁组及≥60岁组，采取问卷调查、体格检查和生化检测进行CHD主要危险因素的测定。结果经标化后北京社区居民高胆固醇血症、高血压、糖尿病、吸烟及肥胖的发病率分别为9．30％，41．57％，10．18％，35．81％及22．89％。高胆固醇血症、高血压及糖尿病发病率随年龄增加均有增高趋势（趋势χ^2值依次为15．6，31．7和18．0，均P〈0．001）。吸烟及肥胖的发病率45—59岁组最高，分别是28．00％和25．27％（均P〈0．01）。在45～59岁组及≥60岁组，将近30％左右的人处于胆固醇边缘升高及血压边缘升高的状态之中，高于40％的人处于体重超重的状态下。经标化后10．4％北京社区居民处于理想水平。22．45％的居民伴有1项以上危险因素的边缘异常。67．15％的居民伴有1项以上的危险因素，其中伴有2项及3项以上危险因素聚集者占21．37％及8．50％。与20—44岁组相比，45～59岁组、≥60岁组发生CHD危险因素聚集的风险分别是2．63倍（95％CI2．371～2．924）、4．3倍（95％C13．764～4．913）。男性与女性相比发生CHD危险因素聚集的风险是4．392（95％CI3．938—4．899）。结论北京社区居民CHD主要危险因素发生率较高。45～59岁组及≥60岁组CHD主要危险因素发生率及聚集风险均较20～44岁组增高，是北京市人群防治的重点。Objective To study the difference in prevalence of major risk factors of coronary heart disease （CHD） in resident from Beijing communities in different age groups so as to offer suggestions for prevention of CHD in Beijing. Methods The samples were selected by random cluster multistage method. Serum lipid level and CI-ID factors were determined through questionnaire, physical examination and biochemical detection for 10 054 subjects in Beijing communities during June 2007 to August 2007. According to age, the subjects were divided into 3 groups： 20 -44 yr group, 45 -59 yr group and ≥60 yr group. Results After age and sex standardization the prevalence of hypercholesterolemia, hypertension, diabetes, smoking and obesity was 9. 30% , 41.57%, 10. 18%, 35.81% and 22. 89% respectively. The prevalence of hypercholesterelemia, hypertension and diabetes showed an rising trend with advancing age （ trend χ^2 ： 15. 6, 31.7 and 18.0, all P 〈 0. 001 ）. The group of 45-59 yr had the highest prevalence in smoking and obesity 28% and 25. 27% respectively. Over 30% in the groups of 45-59 yr and ≥60 yr were in the borderline of hypercholesterolemia and hypertension and over 40% were overweight. After age and sex standardization, 67. 15% of community residents had at least 1 CHD risk factor, 21.37% and 8. 50% 2 or over 3 CHD risk factors. As compared with group 20 -44 yr, the odds ratio （95% CI） for clustering of CHD risk factors in groups 45 - 59 yr and ≥ 60 yr were 2. 63 （95 % CI 2. 371 - 2. 924） and 4. 3 （95 % CI 3.764 - 4. 913） respectively. The odds ratio （95% CI） for clustering of CHD risk factors for male vs female was 4. 392 （95% CI 3.938 -4. 899 ）. Conclusion The prevalence of CHD major risk factors of Beijing community residents is high. Groups of 45 - 59 yr and ≥60 yr have a higher prevalence and clustering of CHD major risk factors than 20 - 44 yr group. So these age groups deserve a higher priority of comprehensive prevention and control strategies of CHD.

关 键 词：高脂血症 冠状动脉疾病 流行病学 

分 类 号：R541.4[医药卫生—心血管疾病]