中国中年人群超敏C反应蛋白与心血管事件、总死亡事件的关联研究  

Association between high-sensitivity C-reactive protein and both cardiovascular, total mortality events in middle-aged Chinese adults

作　　者：董莹 王增武 王馨 田野 张林峰 陈祚 曹慧青[2] Dong Ying;Wang Zengwu;Wang Xin;Tian Ye;Zhang Linfeng;Chen Zuo;Cao Huiqing(Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 102308, China （Dong Y, Wang ZW, Wang X, Tian Y, Zhang LF, Chen Z;Institute of Molecular Medicine, Peking University, Beifing 100871, China （Cao H)

机构地区：[1]中国医学科学院阜外医院国家心血管病中心社区防治部,北京102308 [2]北京大学分子医学研究所,100871

出　　处：《中华流行病学杂志》2018年第4期428-432,共5页Chinese Journal of Epidemiology

基　　金：国家自然科学基金（81373070）

摘　　要：目的 了解超敏C反应蛋白（hs-CRP）与心血管事件、全因死亡事件是否独立相关。方法 2009-2010年在我国12个研究地区各抽取35~64岁调查对象1 000人，实际入选11 623人。收集清晨空腹血标本检测hs-CRP，同时调查心血管病危险因素。2016-2017年对12个地区中的7个地区进行随访，中位随访时间为6.21年（36 075人年），并记录心血管和死亡事件。总共随访6 177例，排除基线感染者、未进行hs-CRP检测和体格测量的研究对象后，5 984例纳入最终分析。根据hs-CRP值（mg/L）将人群分为3组（〈1、1~和〉3）。使用Cox比例风险模型，在调整各混杂因素后，探讨hs-CRP与心血管事件及总死亡事件的关联。结果 随访对象平均年龄50.2岁。hs-CRP〈1、1~和〉3 mg/L 3组人群心血管事件的发生率分别为3.6/1 000人年、7.1/1 000人年和10.4/1 000人年；全因死亡事件发生率分别为3.0/1 000人年、5.7/1 000人年和9.1/1 000人年。调整混杂因素后，与hs-CRP〈1 mg/L组相比，hs-CRP 1~和〉3 mg/L明显增加心血管事件的发生风险，HR值（95% CI）分别为1.33（0.95~1.84）和1.76（1.20~2.60），呈明显上升趋势（趋势检验P=0.003）；发生全因死亡风险也明显增加，HR值（95% CI）分别为1.76（1.23~2.54）和2.64（1.74~4.01），呈明显上升趋势（趋势检验P〈0.001）。结论 hs-CRP增高与心血管事件及全因死亡事件呈独立相关。Objective To estimate the association between high-sensitivity C-reactive protein （hs-CRP） and cardiovascular events as well as all-cause mortality events. Methods During 2009-2010, out of the 11 623 individuals, 1 000 participants aged 35-64 years, were recruited and divided into 12 age-groups, to have received a study on CVD risk factors. Information on the risk factors of cardiovascular diseases was also collected. Fasting blood sample was gathered for all the participants, with hs-CRP tested. Participants in 7 out of the 12 sites were followed, with 6.21 years （36 075 person-years） as the median follow-up period. Cardiovascular and all-cause mortality events were collected. A total of 6 177 participants had been followed after excluding participants who had baseline infections, or did not take hs-CRP test/physical examination at the baseline. Finally, 5 984 participants were included for analysis. Participants were categorized into three groups based on the hs-CRP （mg/L） values：〈1, 1-3 and 〉3, respectively. Cox proportional hazards regression model was used to analyze the relationships between hs-CRP with cardiovascular events or all-cause mortality events, after adjusting for confounding factors. Results Mean age of the participants was 50.2 years. The incidence rates of cardiovascular disease events were 3.6/1 000 person-years, 7.1/1 000 person-years, and 10.4/1 000 person-years among three groups and 3.0/1 000 person-years, 5.7/1 000 person-years, 9.1/1 000 person-years for all-cause mortality events, respectively. After adjusting for confounding factors, the hazard risks （HR） for cardiovascular events were 1.33 （95% CI：0.95-1.84） in the hs-CRP 1-3 mg/L group and 1.76 （95% CI：1.20-2.60） in the hs-CRP〉3 mg/L group when comparing with the hs-CRP〈1 mg/L group （trend test P=0.003）. The HRs for all-cause mortality events were 1.76 （95% CI：1.23-2.54） and 2.64 （95% CI：1.74-4.01） （trend test P〈0.001）, respectively. Conclusion Hs-CRP appeared an independen

关 键 词：超敏C反应蛋白 心血管事件 全因死亡事件 中年人群 

分 类 号：R54[医药卫生—心血管疾病]