心血管健康评分变化对颈动脉内中膜增厚的影响  

Effect of cardiovascular health score on carotid intima-media thickening

作　　者：张莹 杜鑫[2] 李劼 马琳 张树华 吴寿岭[2] Zhang Ying;Du Xin;Li Jie;Ma Lin;Zhang Shuhua;Wu Shouling(Department of Ultrasound,Affiliated Hospital of North China University of Technology,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院超声科,唐山063000 [2]开滦总医院心内科

出　　处：《北京医学》2021年第3期193-197,共5页Beijing Medical Journal

摘　　要：目的探讨心血管健康评分变化对颈动脉内中膜增厚的影响。方法收集参加2006、2010年开滦集团健康体检且在2010年完成颈动脉内中膜厚度(carotid intima-media thickness, CIMT)超声检测者的数据,统计分析4 138例资料完整者的数据,参照美国心脏协会(American Heart Association, AHA)提出的心血管健康评分(cardiovascular health scores, CHS)对受检者进行分组,第1组CHS差值≤-1分,第2组CHS差值=0分,第3组CHS差值≥1分。分析CHS变化与CIMT增厚的关系。结果 2006年平均CHS为(8.95±2.01)分,2010年平均CHS为(8.40±2.23)分,差值为(-0.54±1.84)分。2010年CIMT增厚组802例(19.4%),CIMT正常组3 336例(80.6%),根据CHS差值进行分组,第1组2 103例,第2组897例,第3组1 138例。第1、2、3组的CMIT分别为(0.83±0.16)、(0.82±0.17)、(0.83±0.17)mm;CIMT增厚发生率分别为19.5%、18.1%、20.0%,差异均无统计学意义(P?0.05)。多因素logistic回归分析显示,与CHS差值≤-1分相比,CHS差值≥1分组的CIMT增厚的OR值(95%CI)为0.72(0.58~0.90),P<0.05;CHS每增加1分,发生CIMT增厚的OR值(95%CI)为0.88(0.83~0.92),P<0.001;CHS每增加1分,CIMT增厚的危险系数下降12%。结论较高累积的CHS评分显著降低了CIMT增厚的风险,理想的心血管健康行为状态有助于降低动脉粥样硬化性心血管疾病的风险。Objective To investigate the effect of cardiovascular health score(CHS) on carotid intima-media thickening(CIMT). Methods The data of 4 138 patients who participated in the physical examination of Kailuan Group in 2006,2010 and completed CIMT ultrasonic test in 2010 were collected to analyse. According to CHS proposed by American Heart Association(AHA), the subjects were divided into three groups. The difference of CHS in the first group was ≤-1, the difference of CHS in the second group was 0, and the difference of CHS in the third group was ≥ 1. The relationship between CHS change and CIMT thickening was analyzed. Results The average CHS was(8.95 ± 2.01) points in 2006 and(8.40 ± 2.23)points in 2010, with a difference of(-0.54 ± 1.84) points. In 2010, there were 802 cases(19.4%) in CIMT thickening group and 3 336 cases(80.6%) in CIMT normal group. According to the difference of CHS, there were 2 103 cases in the first group,897 cases in the second group and 1 138 cases in the third group. CMIT in the first, the second, the third group were(0.83 ±0.16),(0.82 ± 0.17),(0.83 ± 0.17) mm, respectively;the incidence of CIMT thickening was 19.5%, 18.1% and 20.0%, respectively, there was no significant difference(P Ⅱ 0.05). Multivariate logistic regression analysis showed that, compared to the group with the difference of CHS ≤-1, the OR value(95%CI) of CIMT thickening was 0.72(0.58-0.90) in the group with difference of CHS ≥ 1(P < 0.05);CHS increases by one point, the OR value(95%CI) of CIMT thickening was 0.88(0.83-0.92), P < 0.001;the risk factor of CIMT thickening decreased by 12% with CHS increased by one point. Conclusions Higher cumulative CHS significantly reduces the risk of CIMT thickening and the ideal cardiovascular health behavior will be helpful to reduce the risk of atherosclerotic cardiovascular diseases.

关 键 词：心血管健康评分 颈动脉内中膜厚度 动脉粥样硬化性心血管疾病 

分 类 号：R743[医药卫生—神经病学与精神病学]