青中年健康体检人群颈动脉斑块形成的危险因素分析  

Risk Factors of Carotid Plaque in Health Screening Population of Young and Middle-aged

作　　者：张旭 李晓利 张金花 白秉学 孙沛 尹慧君 王耀辉 Zhang Xu;Li Xiaoli;Zhang Jinhua(Department of Geriatric Ward,The No.8 Center of PLA General Hospital,Beijing 100091,China)

机构地区：[1]中国人民解放军总医院第八医学中心第一干部病房,北京100091

出　　处：《医学研究杂志》2020年第4期48-51,38,共5页Journal of Medical Research

基　　金：国家自然科学基金资助项目(81300252)。

摘　　要：目的探讨青中年颈动脉斑块形成的危险因素。方法于2011年10月~2012年12月期间,对解放军总医院第八医学中心体检中心健康查体对象610例(年龄18~59岁)行问卷调查、常规检查、化验,超声诊断并测量颈动脉斑块。以48例有颈动脉斑块者为试验组,562例无斑块者为对照组。采用多因素Logistic回归分析年龄、性别、腰围、体重指数、收缩压、舒张压、平均动脉压、心率、吸烟史、饮酒史、高血压病史、糖尿病史、高脂血症病史及肝功能、空腹血糖、血脂、尿素氮、肌酐、尿酸等因素与颈动脉斑块之间的相关性。结果单因素分析显示:有颈动脉斑块者在年龄、男性比例、腹围、吸烟史、饮酒史、收缩压、平均动脉压、舒张压、糖尿病、空腹血糖、尿酸水平方面均高于无颈动脉斑块组(P<0.05)。Logistic回归结果显示,年龄(OR=1.169,95%CI:1.099~1.243,P=0.000)、吸烟(OR=2.949,95%CI:1.548~5.617,P=0.001)和平均动脉压(OR=1.024,95%CI:1.003~1.046,P=0.022)与颈动脉斑块形成高度相关,并以此建立预测模型,结果显示受试者工作特征曲线(ROC)下面积为0.814(95%CI:0.759~0.869),敏感度为87.5%,特异性为67.3%。结论青中年的颈动脉斑块形成与年龄、性别、腹型肥胖、吸烟、饮酒、高血压、糖尿病、高尿酸血症等多种因素相关,但年龄增长、吸烟、高血压是青中年人群颈动脉斑块形成的主要危险因素。Objective To explore the risk factors of carotid plaque formation in young and middle-aged people.Methods From October 2011 to December 2012,610 people aged 18-59 years old under health screening in the No.8 Center of PLA General Hospital were enrolled.Questionnaire,routine examination,laboratory tests and carotid artery ultrasound were performed.According to the presence or absence of carotid plaque,48 patients with carotid plaque were as experimenter and 562 patients without carotid plaque as the controller.Multivariate Logistic regression was used to analyze correlation between carotid plaque and age,sex,waist circumference,body mass index,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate,smoking,drinking,exercise,history of hypertension,diabetes and hyperlipidemia,liver function,fasting blood glucose,blood lipid,urea nitrogen,creatinine and uric acid(UR).Results Univariate analysis showed that prevalence of male and diabetes mellitus,status of smoking and drinking,the level of age,abdominal circumference,SBP,DBP,MAP,fasting blood glucose and UR in group with carotid plaque were higher than those without carotid plaque(P<0.05).Logistic regression showed that age(OR=1.169,95%CI:1.099-1.243,P=0.000),smoking(OR=2.949,95%CI:1.548-5.617,P=0.001),MAP(OR=1.024,95%CI:1.003-1.046,P=0.022)were highly correlated with carotid plaque formation.The established predictive model showed that the area under the ROC(receiver operation curve)was 0.814(95%CI:0.759-0.869),the sensitivity was 87.5%,and the specificity was 67.3%.Conclusion Carotid plaque young and middle-aged is related to multiple factors such as age,sex,abdominal obesity,smoking,drinking,hypertension,diabetes and hyperuricemia.Moreover,aging,smoking and hypertension are the main risk factors for carotid plaque formation.

关 键 词：动脉斑块 增长吸烟 平均动脉压 危险因素 

分 类 号：R345[医药卫生—基础医学]