累积高敏C反应蛋白暴露与全因死亡的关系  

The relationship between cumulative high sensitivity C-reactive protein exposure and all-cause death

作　　者：宁春红 田俊 贾岛 张芮英 赵权辉 于俊杏 李蔚[1,4] 吴寿岭[4] 孙丽霞 

机构地区：[1]华北理工大学研究生院,河北唐山063000 [2]华北理工大学附属医院急诊科 [3]华北理工大学附属医院心内科 [4]开滦总医院心内科

出　　处：《中华高血压杂志》2016年第10期967-973,共7页Chinese Journal of Hypertension

摘　　要：目的探讨累积高敏C反应蛋白（cumhsCRP）暴露与全因死亡的关系。方法选择参加2006-2007年度开滦集团健康体检的人群作为观察对象。并于2008-2009年和2010-2011年分别对该人群进行第二、三次健康体检。最终纳入统计分析的研究对象有55 169人,进行了平均4.92年的随访,且每年通过开滦社会保障信息系统获取死亡信息。将研究对象按cumhsCRP四分位分成4组,比较各组全因死亡事件发生率的差异,采用多因素Cox比例风险模型分析cumhsCRP暴露对全因死亡的影响。结果共有1772人（3.2%）在平均4.92年随访期间内发生全因死亡。cumhsCRP各组的累积全因死亡发生率分别为1.6%、2.4%、3.2%、5.6%。在多因素Cox回归分析中,校正了包括基线高敏C反应蛋白在内的多种混杂因素,结果显示,以cumhsCRP第一四分位组为参照,第二、三、四四分位组发生全因死亡的风险增加,HR值（95%CI）分别为1.19（1.00~1.42）、1.34（1.14~1.58）、1.75（1.49~2.06）;另外,cumhsCRP每增加10mg/L×年,发生全因死亡的HR值（95%CI）为1.05（1.04~1.06）。结论高cumhsCRP暴露是全因死亡的独立危险因素。Objective To investigate the relationship between cumulative high sensitivity C reactive protein（cumhsCRP）exposure and all-cause death（ACD）. Methods Participants were recruited from the health examination records of2006-2007 in Tangshan Kailuan Company,and received the second and third health examination at 2008-2009and2010- 2011. Eventually 55 169 cases were included and been followed up by 4.92 years on average.The information of death were obtained from Kailuan Social Security information system.Participants were divided into four quarterback groups by cumhsCRP exposure,comparing the difference of the incidence of all-cause death in each exposed group. Data was analyzed by Cox proportional hazard regression. Results 1772cases（3.2%）died during the follow-up. The cumulative mortality rate was 1.6%,2.4%,3.2% and 5.6% in each group. After adjusted for other confounding factors（included baseline high sensitivity C reactive protein）,data from the multivariate Cox regression analysis showed that compared to the 1st group,the HR（95% CI）of cumulative mortality rate was 1.19（1.00-1.42）,1.34（1.14-1.58）,1.75（1.49-2.06）in the rest three groups respectively. In addition,while each 10mg/L×year increase of cumhsCRP,the HR（95% CI）of cumulative mortality rate was 1.05（1.04-1.06）. Conclusion High cumhsCRP exposure is an independent risk factor for all-cause mortality.

关 键 词：高敏C反应蛋白 累积暴露 全因死亡 危险因素 

分 类 号：R541[医药卫生—心血管疾病]