理想心血管健康行为和因素对新发颈动脉斑块的影响  

Impact of ideal health behaviors and factors on the newly developed carotid plaques

作　　者：桑大森[1] 陶杰 宋达[1] 黄科宇[3] 许继波[4] 董岩[5] 陈朔华 吴寿岭 

机构地区：[1]保定市第一中心医院心内科,071000 [2] 华北理工大学研究生学院 [3] 华北理工大学附属开滦总医院 [4] 华北理工大学附属开滦总医院唐家庄医院 [5] 华北理工大学附属开滦总医院林西医院

出　　处：《中华心血管病杂志》2015年第9期816-821,共6页Chinese Journal of Cardiology

摘　　要：目的 探讨心血管健康行为和因素对新发颈动脉斑块的影响.方法 分层单纯随机抽取开滦集团在职及离退休职工中年龄≥40岁、既往无卒中、短暂性脑缺血发作、心肌梗死者共5 852名,进行统一问卷调查、血液生化及颈动脉超声检查.纳入2010至2011年超声检查未检出颈动脉斑块且研究资料完整的研究对象2 372名.采用队列研究方法,观察2012至2013年体检时新发颈动脉斑块检出率.采用多因素logistic回归分析心血管健康行为和因素对新发颈动脉斑块的影响.结果 （1）共检出新发斑块359例,检出率为15.1％;具有0～1、2～3、4～5和6～7个理想心血管健康行为和因素研究对象的新发颈动脉斑块检出率分别为23.1％ （43/186）、17.5％（186/1 065）、12.4％（122/986）和5.9％ （8/135）,差异有统计学意义（P ＆lt;0.001）.（2）多因素logistic回归分析显示：校正年龄、性别、高密度脂蛋白胆固醇、心率、高敏C反应蛋白后,与具有0～1个理想心血管健康行为和因素相比,具有4～5和6～7个理想心血管健康行为和因素是颈动脉斑块形成的保护因素,其OR（95％ CI）值分别为0.52（0.34 ～0.80）和0.28（0.12 ～0.64）.结论 理想心血管健康行为和因素的数量越多,新发颈动脉斑块的检出率就越低.理想心血管健康行为和因素能预防颈动脉斑块的发生.Objective To explore the impact of ideal health behaviors on the newly developed carotid plaques.Methods A total of 5 852 employees （including retired employees from Tangshan Kailuan company） aged over 40 years were included in this study through stratified random sampling.Subjects with previous stroke,transient ischemic attack,myocardial infarction were excluded.Results from the unified questionnaire,blood biochemistry measurements and ultrasonography carotid artery measurements were analyzed.Present study analyzed the data from 2 372 participants without carotid plaques in 2010-2011 examinations.The newly developed carotid plaques in 2012-2013 health examinations were observed and multiple logistic regression analysis was used to explore the impact of ideal health behaviors and factors on the newly developed carotid plaques.Results （1） There were 359 subjects with newly developed carotid artery plaques among the 2 372 subjects （15.1%）,prevalence rate was 23.1% （43/186）,17.5% （186/1 065）,12.4% （122/986）,5.9% （8/135） in the groups with 0-1,2-3,4-5 and 6-7 components of ideal cardiovascular health behaviors and factors,respectively（P 〈 0.001）.（2） Multiple logistic regression analysis showed that after adjusting for age,gender,high density lipoprotein cholesterol,heart rate,and high sensitive c-reactive protein,compared to with 0-1 components of ideal cardiovascular health behaviors and factors,participants with 4-5 and 6-7 components of ideal cardiovascular health behaviors and factors were associated with reduced risk of the newly developed carotid plaques,the OR（95 % CI）values were 0.52 （0.34-0.80） and 0.28 （0.12-0.64）,respectively.Conclusion Higher number of ideal cardiovascular health behaviors and factors is associated with lower incidence of newly developed carotid plaques.

关 键 词：健康行为 颈动脉狭窄 动脉粥样硬化 

分 类 号：R543.4[医药卫生—心血管疾病]