西藏地区女性绝经与左心室舒张功能障碍风险分析  

Risk Analysis of Menopause and Left Ventricular Diastolic Dysfunction in Tibetan Women

作　　者：蒋琳琳 陈祚[1] 张林峰[1] 王馨[1] 杨瑛 郑聪毅 亢玉婷 邵澜[1] 田野[1] 王增武[1] Jiang Linlin;Chen Zuo;Zhang Linfeng(Division of Prevention and Community Health,National Center for Cardiovascular Disease,National Clinical Research Center of Cardiovascular Disease,State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,Peking Union Medical College&Chinese Academy of Medical Sciences,Beijing 102308,China)

机构地区：[1]北京协和医学院/中国医学科学院阜外医院、国家心血管病中心社区防治部、国家心血管病重点实验室、国家心血管病临床试验中心,102308

出　　处：《医学研究杂志》2020年第8期33-37,23,共6页Journal of Medical Research

基　　金：国家公益性行业科研专项基金资助项目(201402002)。

摘　　要：目的探讨我国西藏地区女性不同绝经时期左心室舒张功能障碍(LVDD)的患病风险。方法2015-2016年采用分层多阶段随机抽样的方法对西藏地区常住居民进行慢性心肺疾病调查,最终获得40~60岁女性的有效样本853例。计算各绝经时期的构成比和LVDD发生率,用多因索Logistic回归模型计算女性不同绝经时期的LVDD患病风险。结果未绝经、绝经早期和绝经晚期女性比例分别是56.0%.21.8%和22.2%,相应LVDD发生率分别为16.3%.35.5%和47.1%。伴有高血压或腹型肥胖的女性LVDD发生率显著高于无上述症状的女性。以未绝经女性为参照,调整年龄等混杂因素后的Logistic回归分析显示,绝经早期女性的LVDD患病风险增加(OR=1.881,95%6 CI:1.186-2.982),绝经晚期女性风险进一步升高(OR=2.877,95%CI:1.650-5.017);在高血压对象中,绝经早期与绝经晚期女性LVDD患病风险OR值分别为2.399(95%CI:1.220~4.719)和2.940(95%CI:1.226~7.048);在腹型肥胖对象中,OR值则分别为2.124(95%CI:1.222~3.690)和2.974(95%CI:1.451~6.095)。但在非高血压和非腹型肥胖的女性中,绝经早期LVDD患病风险的升高无统计学意义。结论西藏地区女性绝经后LVDD患病风险增高,高血压和腹型肥胖对象更显著,应针对这类人群进行尽早干预。Objective To investigate the risk of left ventricular diastolic dysfunction(LVDD)at different menopausal periods in Tibetan women.Methods From 2015 to 2016,a multi-stage stratified random sampling method was used for chronic cardiopulmonary disease survey of residents in Tibet.Finally,853 valid samples of women aged 40-60 were obtained.Proportion and prevalence of LVDD were calculated for each menopausal period,and multivariate Logistic regression model was used to calculate LVDD risk in women at different menopausal periods.Results The proportion of non-menopausal,early and late stage postmenopausal women were 56.0%,21.8%and 22.2%,respectively.The prevalence of LVDD in women with hypertension or abdominal obesity was significantly higher than their counterparts during the same period of menopause.After adjusting for age and other confounders,Logistic regression analysis showed that LVDD risk increased in early stage postmenopausal women(OR=1.881,95%CI:1.186-2.982)and late stage postmenopausal women(OR=2.877,95%CI:1.650-5.017)compared with non-menopausal women.In participants with hypertension,the risk of LVDD was significantly increased in both early and late stage postmenopausal women,with OR values were 2.399(95%CI:1.220-4.719)and 2.940(95%CI:1.226-7.048),respectively.In participants with abdominal obesity,the OR values were 2.124(95%CI:1.222-3.690)and 2.974(95%CI:1.451-6.095),respectively.However,among women without hypertension or abdominal obesity,the increased risk of LVDD during early stage of menopause had no statistical significance.Conclusion The risk of LVDD is higher in postmenopausal women in Tibet,especially in those with hypertension or abdominal obesity.Therefore,early interventions should be targeted at these groups.

关 键 词：绝经左心室舒张功能障碍 高血压腹 型肥胖 

分 类 号：R541[医药卫生—心血管疾病]