中老年人群健康行为和因素与臂踝动脉脉搏波传导速度的关系  

Relationship between health behaviors and factors and brachial-ankle pulse wave velocity in middle-aged and elderly population

作　　者：郑晓明[1] 刘红敏[1] 陈冀 桑大森[1] 张倩[1] 李俊娟[1] 吴寿岭[1] 

机构地区：[1]河北联合大学附属唐山开滦总医院心内科,河北唐山063000 [2]开滦建设医院

出　　处：《中华高血压杂志》2012年第12期1157-1162,共6页Chinese Journal of Hypertension

摘　　要：目的探讨中老年人群健康行为和因素对动脉血管的保护作用。方法随机分层抽取唐山开滦(集团)有限责任公司在职及离退休职工中年龄≥40岁、既往无脑卒中、短暂性脑缺血发作、心肌梗死者共5440例为调查对象,根据臂踝动脉脉搏波传导速度(baPWV)分为动脉硬化组(baPWV≥1400cm/s)和非动脉硬化组(baPWV<1400cm/s)。多因素Logistic回归分析心血管健康行为(吸烟习惯、体质量指数、体育锻炼、健康饮食)和因素(总胆固醇、血压、空腹血糖)对baPWV的影响。结果动脉硬化组的年龄、男性比例、吸烟比例、体育锻炼比例、baPWV、体质量指数、收缩压、舒张压、总胆固醇、空腹血糖、低密度脂蛋白胆固醇(LDL-C)、三酰甘油高于非动脉硬化组,高密度脂蛋白胆固醇(HDL-C)低于非动脉硬化组(均P<0.05)。随着心血管健康行为和因素个数的增加,baPWV逐渐降低[右侧baPWV依次为(1646.1±325.0)、(1620.8±317.3)、(1586.4±360.0)、(1564.2±370.1)、(1528.7±376.8)、(1458.6±388.2)、(1393.4±360.9)、(1207.8±212.6)cm/s],动脉硬化发生率逐渐降低(84.5%、77.3%、68.6%、65.0%、57.8%、45.6%、35.7%、13.0%;P<0.05)。Logistic回归分析显示校正了年龄、性别、三酰甘油、LDL-C、HDL-C后,同具有≤1项者相比,具有2、3、4、5和≥6项的理想心血管健康行为和因素是动脉硬化的保护因素,OR(95%CI)分别是0.601(0.460～0.785)、0.536(0.410～0.699)、0.398(0.300～0.528)、0.248(0.179～0.343)、0.161(0.101～0.255)。结论中老年人群心血管健康行为和因素对动脉血管有保护作用。Objective To explore the effect of cardiovascular health behaviors and factors on atherosclerosis in mid- dle-aged and elderly population. Methods A total of 5440 over 40-year old employees from Tangshan Kailuan Company were recruited by stratified random sampling and devided into non-atherosclerosis group [brachial-ankle pulse wave velocity （baPWV）〈1400 cm/s] or atheroselerosis group （baPWV≥1400 cm/s）. Subjects with previous stroke, TIA, myocardial infarction were excluded. Multivariate Logistic regression analysis was used to analyze the effect of health behaviors （including smoking, body mass index, physical activity and health diet） and factors （including total cholesterol, blood pressure and fasting plasma glucose） on baPWV. Results In atherosclerosis group, the proportion of male and current smoking were higher, and physical activity was more common. The age, baPWV, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, fasting blood glucose, low density lipoprotein and triglyceride in atherosclerosis group were significantly higher than those in non-athero- sclerosis group, while high density ]ipoprotein was significantly lower （all P〈0. 05）. With the increasing cardiovas- cular health behaviors and factors, the baPWV decreased, which was （ 1646.1± 325.0 ）, （ 1620.8 ± 317.3 ）, （1586.4±360.0）, （1564.2±370.1）, （1528.7±376.8）, （1458.6±388.2）, （1393.4±360.9） and （1207.8±212.6） cm/s respectively; and the prevalence of atherosclerosis decreased, which was 84. 5%, 77.3%, 68. 6%, 65.0%, 57.8%, 45.6%, 35.7% and 13.0% respectively （P〈0.05）. After adjusting the age, sex, low density lipoprotein, triglyceride and high density lipoprotein, multivariate logistic regression analysis showed individuals withmore than 2 of cardiovascular health behaviors and factors showed lower risk of atherosclerosis [OR = 0. 601 （0. 460-0. 785）, 0. 536 （0. 410-0. 699）, 0. 398 （0.300-0. 528）, 0. 248（0. 179-0. 343）, 0. 16

关 键 词：心血管健康行为和因素 臂踝动脉脉搏波传导速度 动脉硬化 

分 类 号：R543[医药卫生—心血管疾病]