代谢综合征对高血压前期人群心脑血管事件的影响  

Impact of metabolic syndrome on cardio-cerebral vascular events in pre-hypertensive population

作　　者：吴寿岭[1] 张颖[2] 阮春雨[1] 田琪[1] 金成[1] 李金锋[1] 孙玉艳[2] 黄卫[2] 钟吉文[2] 蔡军[3] 

机构地区：[1]河北联合大学附属开滦医院心内科,唐山063000 [2]河北联合大学 [3]首都医科大学附属北京朝阳医院心内科

出　　处：《中华心血管病杂志》2012年第5期397-401,共5页Chinese Journal of Cardiology

摘　　要：目的探讨代谢综合征对高血压前期人群心脑血管事件的影响。方法采用前瞻性队列研究方法，以参加2006年7月至2007年10月健康查体的10l510名开滦集团在职及离退休职工中30～70岁的高血压前期者（符合JNC-7诊断标准，29968例）作为观察队列，并依据中国成人血脂异常防治指南对2004年中华医学会糖尿病学分会建议的修订将其分为代谢综合征阴性组和代谢综合征阳性组。随访38～53（47．35±4．68）月，随访期间每半年收集1次新发心脑血管事件情况。用Kaplan—Meier法计算代谢综合征阴性组和代谢综合征阳性组心脑血管事件的累积发病率，并用logrank法检验。采用多变量Cox比例风险回归模型分析影响心脑血管事件发生的因素。结果（1）随访期间，代谢综合征阳性组总心脑血管事件、心肌梗死、脑梗死的累积发病率均高于代谢综合征阴性组，分别为1．80％比1．28％、0．35％比0．29％、1．10％比0．57％，其中总心脑血管事件、脑梗死事件组间差异有统计学意义（P〈0．01）；（2）校正相关因素后，与代谢综合征阴性组相比，代谢综合征阳性组总心脑血管事件和脑梗死事件的相对危险度（RR）分别为1．45（95％CI：1．10～1．92）、1．84（95％CI：1．27—2．67）。结论代谢综合征可增加高血压前期人群发生心脑血管疾病的危险。Objective This study investigated the impact of metabolic syndrome on the development of cardio-cerebral vascular （CVD） events in a pre-hypertensive population. Methods The data used in this prospective study was derived from the Kailuan study cohort （n = 101 510）. Prehypertension was diagnosed in 29 968 （ mean age ： 50 ± 9 years and 23 744 males） individuals by the JNC VII criteria and these subjects were further classified into metabolic syndrome positive （ MS ＋ , n = 3447） and MS negative （ MS - , n = 26 521 ） groups according to the modified 2004 Chinese Diabetes Society criteria. Subjects were followed up for 38- 53 （mean 47 ± 5 ） months and first-ever CVD events were recorded. Baseline anthropometric and laboratory features were obtained by physical examination from June 2006 to October 2007 and the last follow-up day was December 31, 2010. Muhivariable Cox proportional hazards regression models were used to analyze the risk factors of first-ever CVD events. Results There were 354 CVD events during follow up. The incidences of CVD events （ 1.80% vs. 1.28% ） and cerebral infarction （ 1.10% vs. 0. 57% ） were significantly higher in the MS ＋ group than in the MS - group （ all P 〈 0. 05 ）. After adjustment for other established CVD risk factors, the hazards ratio was 1.45 （95% CI： 1.10 -1.92） for total CVD events and 1.84 （95% CI： 1.27 -2. 67 ） for cerebral infarction events in MS ＋ group. Conclusions In this cohort, metabolic syndrome is linked with increased risk for CVD events.

关 键 词：代谢综合征 高血压 队列研究 

分 类 号：R544.1[医药卫生—心血管疾病]