主动脉瓣硬化临床危险因素分析  

Clinical Risk Factors of Aortic Valve Sclerosis

作　　者：杨洋[1] 张宝娓[1] 杨颖[1] 齐丽彤[1] 陈峰[1] 王淑玉 刘力生 赵锋[1] 丁文惠[1] 霍勇[1] 

机构地区：[1]北京大学第一临床医院心脏内科,北京市100034 [2]北京高血压联盟

出　　处：《中国动脉硬化杂志》2011年第2期139-142,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的通过横断面研究,了解主动脉瓣硬化在一组高危人群中发病情况,并评价主动脉瓣硬化的临床危险因素。方法 1058例首钢社区动脉硬化调查的队列人群,排除了风湿性瓣膜病、主动脉瓣二叶瓣畸形、人工瓣膜置换术后、主动脉瓣狭窄。测定并评价心血管疾病的危险因素(包括年龄、血压、血糖、血脂、体质指数和吸烟情况)。根据经胸心脏超声评价主动脉瓣硬化病变情况,并将人群分为主动脉瓣硬化组和主动脉瓣正常组。结果最终入选1039例人群,平均年龄62.47±8.99岁,明确患有高血压病占68.72%,糖尿病占25.89%。发生主动脉瓣硬化401例(38.59%)。年龄每增加10岁是原来发生瓣膜硬化危险的1.589倍(P<0.001);男性发生瓣膜硬化的危险是女性的2.263倍(P<0.001);患高血压病人群发生瓣膜硬化的危险是无高血压的1.296倍(P=0.063),而患糖尿病的人发生瓣膜硬化的危险是无糖尿病的1.794倍(P<0.001)。经多因素Logistic回归分析,发现主动脉瓣硬化独立危险因素包括年龄增加(OR=1.507,P<0.001)、男性(OR=1.974,P=0.003)、高血压(OR=1.428,P=0.015)和糖尿病(OR=1.719,P<0.001)。结论主动脉瓣硬化的发生是多个因素共同参与的复杂病理过程。主动脉瓣硬化与动脉硬化有着许多共同的危险因素,提示这些危险因素可能通过类似的机制参与了瓣膜硬化发生、发展过程。Aim To investigate the prevalence of aortic valve sclerosis（AVS） in the high-risk group of cardio-cerebral vascular events,and to evaluate the clinical risk factors of AVS. Methods 1058 individuals were enrolled in the cohort of the community of the Capital Steel Corporation in 2005.Participants were excluded if they had a history of any of the following diseases：rheumatic valve disease,bicuspid aortic valve malformation,prosthetic valve replacement,aortic valve stenosis.Risk factor status（including smoking,hypertension and diabetes etc） were adjudicated based on a review of data collected from hospitalizations and outpatient records.Total cholesterol and high density lipoprotein（HDL） cholesterol,triglycerides were measured from blood samples.Transthoracic echocardiography was performed to access the aortic valve sclerosis.And according to the results of the echocardiography,population was divided into two groups： AVS group and non-AVS group. Results 1039 individuals were included in this study finally with mean age 62.47±8.99 years old.The prevalence of hypertension of 1039 individuals was 68.72% and of diabetes mellitus was 25.89%.AVS was present in 401 individuals（38.59%）.The risk factors of AVS included age（OR=1.589,P0.001）,male（OR=2.263,P0.001）,hypertension（OR=1.296,P=0.063）,diabetes mellitus（OR=1.794,P0.001）.However after multivariate Logistic regression analysis,the independent risk factors of AVS included age（OR=1.507,P0.001）,male（OR=1.974,P=0.003）,hypertension（OR=1.428,P=0.015）,diabetes mellitus（OR=1.719,P0.001）. Conclusion Multiple risk factors may involve in the progress of AVS.AVS and arteriosclerosis have some same risk factors which indicates that some factors for atherosclerosis may also play an important role in the prevalence of aortic valve sclerosis.

关 键 词：主动脉瓣硬化 危险因素 超声心动图 

分 类 号：R5[医药卫生—内科学]