China-PAR模型与Framingham危险评分对中国绝经后女性健康体检人群心血管疾病风险评估的比较研究  

A comparative study of China-PAR model and Framingham risk score on cardiovascular disease risk assessment in Chinese postmenopausal women

作　　者：马孝湘[1] 王林[1] 杨雁华[1] 左晓娇[1] 龚立荣[1] 刘玉萍[1] MA Xiaoxiang;WANG lin;YANG Yanhua;ZUO Xiaojiao;GONG Lirong;LIU Yuping(Center of Health Management,Sichuan Academy of Medical Sciences·Sichuan Provincial People’s Hospital,Chengdu,610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院健康管理中心,成都610072

出　　处：《临床心血管病杂志》2021年第1期38-41,共4页Journal of Clinical Cardiology

基　　金：四川省干部保健科研课题(No:川干研2020-216)。

摘　　要：目的:比较美国Framingham危险评分(FRS)和中国动脉粥样硬化性心血管疾病风险预测模型(China-PAR)对中国绝经后女性健康体检人群10年心血管疾病(CVD)发病风险评估的差异,以期找到可更加准确地评估该人群10年CVD发病风险的方法。方法:回顾性选取进行健康体检的绝经后女性4100例,对所有研究对象进行问卷调查、体格检查和血清学检测,同时分别应用FRS与China-PAR模型预测其未来10年患CVD的发病风险,比较这两种评估方法预测结果的一致性。结果:(1)China-PAR模型显示,中国绝经后女性健康体检人群10年CVD绝对风险的均数为7.2%,其中低危比例为40.2%,中危比例为50.9%,高危比例为8.9%;FRS显示,该人群10年CVD绝对风险的均数为9.9%,其中低危比例为32.1%,中危比例为47.8%,高危比例为20.1%。两种方法预测结果相比较,均数、低危及高危比例间差异均有统计学意义(P<0.05)。(2)两种方法预测不同年龄人群中的低危、中危和高危3个危险度评估结果差异均有统计学意义,且不同年龄人群发病风险等级结果一致,年龄越高,CVD 10年发病风险的危险等级越高。(3)两种方法预测结果的一致性较差,一致性检验Kappa=0.139<0.40(P<0.05)。结论:China-PAR模型预测中国绝经后女性健康体检人群未来10年CVD发病风险的平均风险和高危比例均低于美国FRS,这两种方法预测结果的一致性较差,China-PAR可能更适用于中国绝经后女性健康体检人群。Objective:To compare the difference between Framingham risk score(FRS)and Chinese atherosclerotic cardiovascular disease risk prediction model(China-PAR)in the risk assessment of 10-year cardiovascular disease(CVD)in Chinese postmenopausal women,so as to find a more accurate method to assess the risk of CVD in this population.Methods:A total of 4100 postmenopausal women who underwent physical examination were retrospectively selected.All the subjects were investigated by questionnaire,physical examination,and serological test.FRS and China-PAR model were used to predict the risk of CVD in all the subjects in the next 10 years.Results:(1)The mean value of CVD absolute risk predicted by China-PAR model and FRS was 7.2%and 9.9%,respectively.There were significant differences in mean value and low-risk ratio between the two methods(all P<0.05).(2)There was significant difference between the two methods in predicting the three risk assessment results of low,medium,and high risk in different age groups(all P<0.05),and the results of risk level of different age groups were the same.(3)The consistency of the two methods was poor,and Kappa=0.139<0.40(P<0.05).Conclusion:The average risk and high-risk ratio of CVD in Chinese postmenopausal women health examination population predicted by China-PAR model in the next 10 years are lower than those predicted by FRS in the United States.The prediction results of these two methods have poor consistency,and China-PAR may be more suitable for Chinese postmenopausal women with physical examination.

关 键 词：心血管疾病 风险评估 China-PAR模型 Framingham危险评分 绝经后女性 

分 类 号：R541[医药卫生—心血管疾病]