中老年人群理想心血管健康评分变化和踝臂指数的关系  

Relationship Between Change of Ideal Cardiovascular Health Score and Ankle Brachial Index in Elderly Population

作　　者：刘雪梅[1] 黄玮[1] 聂维齐 邵丹[1] 李晓庆[1] 张莹 吴寿岭[4] LIU Xue-Mei HUANG Wei NIE Wei-Qi SHAO Dan LI Xiao-Qing ZHANG Ying WU Shou-Ling(Department of Physical Diagnosis, Kailuan General Hospital Department of Function Inspection, Tangshan Hospital for Infectious Diseases Department of Ultrusonography, Affiliated Hospital of North China University of Science and Tech- nology Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei 063000, China)

机构地区：[1]开滦总医院物理诊断科 [2]唐山市传染病院功能检查科 [3]华北理工大学附属医院超声科 [4]开滦总医院心内科,河北省唐山市063000

出　　处：《中国动脉硬化杂志》2016年第10期1044-1049,共6页Chinese Journal of Arteriosclerosis

基　　金：国家科技支撑计划项目(2008BAI52B03)

摘　　要：目的探讨中老年人群理想心血管健康评分变化（△ICHS）与踝臂指数（ABI）的关系。方法在101510名参加2006-2007年开滦集团职工体检者中,随机分层抽取5852人作为研究对象,其中符合入选标准者5440例。每2年1次体检,并于2010-2011年再次体检时增加ABI。去除数据缺失者,最终纳入统计分析的研究对象为4524例。按照美国心脏协会提出的7项心血管健康指标,将人群进行理想心血管健康评分（ICHS）。根据2006-2007、2010-2011年2次体检的△ICHS,采用线性回归和Logistic回归分析△ICHS与ABI的关系。结果随着△ICHS由低向高转变,△收缩压、△舒张压、△体质指数、△总胆固醇及△空腹血糖均呈逐渐下降趋势（P〈0.05）,理想食盐习惯和体育锻炼人群比例明显改善,分别升高了9.3%和17.2%,理想吸烟人群比例下降约4.6%。总人群的收缩压、舒张压、体质指数、总胆固醇及空腹血糖均较基线时略有升高。ABI随△ICHS升高呈逐渐升高趋势（P〈0.05）。线性回归结果显示：△ICHS与ABI呈正相关,在校正多种混杂因素之后,△ICHS每增加1分,ABI升高0.004（B值：0.004,P=0.004）。Logistic回归分析也显示：在校正多种混杂因素之后,与ICHS降低组相比较,ICHS不变组和ICHS升高组的ABI异常呈下降趋势,△ICHS每增加1分,ABI异常风险降低约21%（OR：0.79,95%CI：0.68～0.91）。结论△ICHS与ABI呈正相关。△ICHS是中老年人群动脉硬化的独立预测因素。Aim To explore the relationship between change of ideal cardiovascular health score（ △ICHS） and the ankle-brachial index（ ABI） in the elderly population. Methods Through stratified random sampling,a total of5852 cases were enrolled from 101510 Kailuan Group employees who participated in the health examination in 2006-2007,and among which 5440 individuals met the inclusion criteria. 1 physical examination every 2 years,and ABI was measured by ultrosoud in 2010-2011 examination. Excluding the incomplete data,4524 cases were included for the final analysis. Ideal cardiovascular health score（ ICHS） was performed in the population,according to the 7 cardiovascular health indexes proposed by the American Heart Association. According to the △ICHS of 2006-2007,2010-2011 examination,the relationship between △ICHS and ABI was analyzed by linear regression and Logistic regression. Results With the△ICHS changed from low to high,△SBP,△DBP,△BMI,△TC and △FBG all decreased（ P〈0. 05）. The proportions of ideal salt habit and physical exercise population significantly increased by about 9. 3% and 17. 2% respectively,and the proportion of ideal smoking population decreased by about 4. 6%. SBP,DBP,BMI,TC and FBG were slightlyhigher than that in baseline. With the increase of △ICHS,ABI gradually increased（ P〈0. 05）. Linear regression analysis showed that △ICHS was positively related with ABI,and after adjusting for various confounding factors,the△ICHS increased by 1 point,ABI increased by 0. 004（ B = 0. 004,P = 0. 004）. Logistic regression analysis showed that after adjusting for various confounding factors,compared with the ICHS reducing group,the ABI abnormality of ICHS invariant group and ICHS elevating group revealed a downward trend. The △ICHS increased by 1 point,abnormal ABI risk reduced by about 21%（ OR： 0. 79,95% CI： 0. 68-0. 91）. Conclusions △ICHS is positively correlated with ABI. △ICHS is an independent predictor of atherosclerosis in the elderly population.

关 键 词：理想心血管健康评分 踝臂指数 动脉粥样硬化 

分 类 号：R18[医药卫生—流行病学]