上海市浦东新区队列人群危险因素与冠心病发病的关联性分析  

Correlation analysis of risk factors and coronary heart disease incidence in the cohort of Shanghai Pudong New Area

作　　者：柯居中 吴抗 刘晓琳 邱桦 王文静 王小楠 阮晓楠 林涛 KE Juzhong;WU Kang;LIU Xiaolin;QIU Hua;WANG Wenjing;WANG Xiaonan;YUAN Xiaonan;LIN Tao(Shanghai Pudong New Area Center for Disease Control and Prevention Pudong Institute of Preventive Medicine,Fudan University,Shanghai 200136,China;Center for Clinical Research and Translational Medicine,Yangpu Hospital,Tongji University,Shanghai 200090,China)

机构地区：[1]上海市浦东新区疾病预防控制中心复旦大学浦东预防医学研究院,上海200136 [2]上海市杨浦区中心医院(同济大学附属杨浦医院)临床研究与转化医学中心,上海200090

出　　处：《中国医药导报》2021年第20期46-50,共5页China Medical Herald

基　　金：上海市浦东新区卫生计生委面上项目(PW2017A-11);上海市浦东新区科技发展基金创新资金项目(PKJ2010-Y04)。

摘　　要：目的了解浦东新区冠心病的发病情况,探讨冠心病危险因素水平与发病的关联性。方法采用前瞻性队列研究方法,2013年起对浦东新区15岁以上社区居民进行基线调查,随访观察至2016年12月31日,记录调查对象在随访期间的冠心病发病情况并与危险因素水平做关联性分析。结果队列随访观察中位时间为3.00年,共随访到273例患者发生冠心病,冠心病累积发病率为3.96%,发病密度13.45/千人年。高龄、离婚或丧偶、居住在农村、睡眠<7 h、中心性肥胖、患有高血压的人群中冠心病发病率显著高于对照人群,差异有统计学意义(P<0.05)。冠心病患者三酰甘油、低密度脂蛋白、餐后2 h血糖、糖化血红蛋白、C反应蛋白均高于未发生冠心病人群,差异有统计学意义(P<0.05)。Cox回归分析显示,年龄≥55岁、高血压、睡眠<7 h、中心性肥胖是冠心病发生的影响因素(HR>1,P<0.05)。结论浦东新区冠心病防控形势严峻,针对高血压、睡眠不足、中心性肥胖的干预是冠心病预防工作的重点。Objective To understand the incidence of coronary heart disease in Pudong New Area,and to explore the correlation between the level of coronary heart disease risk factors and the incidence.Methods Using a prospective cohort study method,a baseline survey of community residents over the age of 15 in Pudong New Area was conducted in 2013,and follow-up observations were conducted until December 31,2016.The incidence of coronary heart disease during the follow-up period was recorded and correlation analysis with the level of risk factors was performanced.Results The median follow-up observation time of the cohort was 3.00 years.A total of 273 cases of coronary heart disease were followed up.The cumulative incidence of coronary heart disease was 3.96%,and the incidence density was 13.45 per thousand person-years.The incidence of coronary heart disease among people with old age,divorced or widowed,living in rural areas,sleep<7 h,central obesity,and hypertension were significantly higher than those of the control population,and the differences were statistically significant(P<0.05).The levels of triacylglycerol,low-density lipoprotein,blood glucose,glycosylated hemoglobin,and C-reactive protein in patients with coronary heart disease were higher than those without coronary heart disease(P<0.05).Cox regression analysis showed that age≥55 years,hypertension,sleep<7 h,and central obesity were the influencing factors of coronary heart disease(OR>1,P<0.05).Conclusion The prevention and control situation of coronary heart disease in Pudong New Area is severe.Interventions for hypertension,lack of sleep,and central obesity are the focus of coronary heart disease prevention.

关 键 词：队列研究 冠心病 发病率 危险因素 

分 类 号：R541[医药卫生—心血管疾病]