高密度脂蛋白胆固醇和颈动脉内膜中层厚度对飞行人员心血管风险的预测价值  

Analysis of the value of HDL- C and IMT in predicting pilots' risks of cardiovascular events

作　　者：李梦豪 卢浩[1] 刘季晨 罗甜甜[1] 熊浩伟 习丹[1] 赵金珍[1] 赖文岩[1] 郭志刚[1] 

机构地区：[1]南方医科大学南方医院心内科

出　　处：《广东医学》2016年第5期739-743,共5页Guangdong Medical Journal

基　　金：广东省教育部产学研结合项目(编号:2012B091100155)

摘　　要：目的分析飞行人员心血管疾病风险因素,为准确预测心血管事件发生率,针对性控制风险因素,减少飞行人员心血管事件的发生提供依据。方法选取参与体检的151名飞行人员的体检资料,对其进行心血管风险评分,比较不同高密度脂蛋白胆固醇(HDL-C)水平人群的颈动脉内膜中层厚度(IMT)、Framingham评分、国人10年缺血性心血管病(ICVD)风险评分、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖及5项炎症因子:白细胞介素-6(IL-6)、C反应蛋白(CRP)、可溶性细胞间黏附分子-1(s ICAM-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)、载脂蛋白B(apo B)等指标,并对HDL-C、IMT与其他指标的相关性进行分析。结果低HDL-C组与正常HDL-C组、高HDL-C组在Framingham评分、国人10年ICVD风险、TG、IMT方面差异有统计学意义(P<0.05);HDL-C水平与TG、IMT、体质指数(BMI)存在明显负相关(P<0.05);IMT与Framingham评分、国人10年ICVD风险评分、HDL-C、BMI、TG明显相关(P<0.05)。结论 HDL-C水平及IMT值可准确预测飞行人员未来10年的心血管病发病风险;严格戒烟、减重将可能使HDL-C水平得到提升,从而减少动脉斑块的形成,降低其心血管风险。Objective To investigate the risk factors for cardiovascular events in pilots,and thus provide evidence for predicting the incidence of cardiovascular events,precise controlling of the risk factors and reducing the occurrence of such events in pilots. Methods 151 pilots participating in the medical examination were included in this study.The carotid intima- media thickness（ IMT）,Framingham risk score,10- year risk score for ischemic cardiovascular disease（ ICVD） in Chinese,triglycerides（ TG）,total cholesterol（ TC）,low- density lipoprotein cholesterol（ LDL- C）,fasting blood- glucose and five inflammatory factors including interleukin- 6（ IL- 6）,c- reactive protein（ CRP）,soluble intercellular adhesion molecule 1（ sICAM- 1）,lipoprotein- associated phospholipase A2（ Lp- PLA2）,apolipoprotein B（ apo B）,and other indicators were measured and compared between different groups based on different high- density lipoprotein cholesterol（ HDL- C） levels. The correlations between HDL- C,IMT and other indicators were analyzed as well. Results Significant differences in the Framingham risk score,10- year risk score for ICVD in Chinese,TG,IMT were detected between low level of HDL- C group and normal level of HDL- C group,as well as those between the low HDL- C group and the high HDL- C group（ P〈0. 05）. HDL- C level was negatively correlated with TG,IMT and body mass index（ BMI）（ P〈0. 05）. And significant correlation of IMT with Framingham risk score,10- year risk score for ICVD in Chinese,HDL- C,BMI and TG was detected（ P〈0. 05）. Conclusion HDL- C and IMT can be used to accurately predict the risk for cardiovascular events in the next ten years in pilots. Rigorous smoking cessation and weight- controlling could improve the HDL- C level,thus the formation of arterial plaques can be reduced and the risk for cardiovascular events in pilots can be lowered.

关 键 词：飞行员 心血管风险 颈动脉内膜中层厚度 高密度脂蛋白胆固醇 炎症因子 

分 类 号：R446.112[医药卫生—诊断学]