围绝经期妇女并发冠状动脉粥样硬化性心脏病的危险因素和风险模型构建  

Risk factors and risk model construction of perimenopausal women complicated with coronary atherosclerotic heart disease

作　　者：钱菊英 邵翠颖[1] 于志芳[1] QIAN Ju-Ying;SHAO Cui-Ying;YU Zhi-Fang(The Second Affiliated Hospital of Jiaxing University,the Second Hospital of Jiaxing,Jiaxing,Zhejiang 314000,China)

机构地区：[1]嘉兴学院附属第二医院嘉兴市第二医院,浙江嘉兴314001

出　　处：《中国妇幼保健》2022年第11期2100-2103,共4页Maternal and Child Health Care of China

基　　金：浙江省嘉兴市科技局项目(2018AD32037)。

摘　　要：目的探讨围绝经期妇女并发冠状动脉粥样硬化性心脏病(CHD)的危险因素并构建相应的风险模型。方法选取2019年1月—2021年12月就诊于嘉兴学院附属第二医院的690例围绝经期妇女为研究对象,根据冠脉造影结果分为合并CHD组(87例)和未合并CHD组(603例)。比较两组患者的临床和实验室检查资料,分析围绝经期妇女合并CHD的相关危险因素并通过二元Logistic回归构建风险模型,通过受试者工作特征曲线评估该模型的效能。结果同未合并CHD的围绝经期妇女相比,合并CHD的围绝经期妇女体质指数[(26.172±2.863)kg/m^(2)]、高血压比例(52.87%)、糖尿病比例(24.14%)、吸烟比例(16.09%)、CHD家族史比例(21.84%)、脑卒中比例(8.05%)、平均血小板体积[(11.847±1.034)fl]、血小板分布宽度[(16.463±3.090)%]、三酰甘油[(2.107±0.569)mmol/L]、低密度脂蛋白[(4.948±0.846)mmol/L]和总胆固醇水平[(6.617±0.989)mmol/L]均显著升高,而卵泡刺激素[(2.899±0.288)μg/L]、黄体生成素[(1.873±0.235)μg/L]和雌二醇水平[(40.777±10.100)pmol/L]均显著下降,差异均有统计学意义(t=7.478,P<0.001;χ^(2)=34.459,P<0.001;χ^(2)=14.771,P<0.001;χ^(2)=9.429,P=0.002;χ^(2)=25.426,P<0.001;χ^(2)=6.007,P=0.014;t=6.730,P<0.001;t=8.207,P<0.001;t=2.067,P=0.041;t=15.876,P<0.001;t=15.856,P<0.001;t=-95.953,P<0.001;t=-111.451,P<0.001;t=-104.275,P<0.001)。二元Logistic回归结果显示,患者体质指数、高血压、糖尿病、吸烟、CHD家族史、脑卒中、平均血小板体积>11 fl、血小板分布宽度>13%、低密度脂蛋白>3.4 mmol/L、卵泡刺激素、黄体生成素及雌二醇水平是影响围绝经期妇女合并冠状动脉粥样硬化性心脏病的因素。受试者工作特征曲线显示,风险模型鉴别围绝经期妇女是否合并CHD的曲线下面积为0.890,灵敏度为93.44%,特异度为73.21%。结论雌激素水平降低是围绝经期妇女合并CHD的危险因素。本研究所构建的风险模型可能有助于�Objective To investigate the risk factors of coronary atherosclerotic heart disease(CHD)in perimenopausal women and to construct a corresponding risk model.Methods A total of 690 perimenopausal women who visited Jiaxing Second Hospital from January 2019 to January 2021 were selected as the research objects.According to the results of coronary angiography,they were divided into CHD group(n=87)and non-CHD group(n=603).The clinical and laboratory examination data of the two groups of patients were compared,the related risk factors of CHD in perimenopausal women were analyzed,and the risk model was constructed by binary logistic regression.Results Compared with perimenopausal women without CHD,perimenopausal women with CHD had significantly higher levels of body mass index[(26.172±2.863)kg/m^(2)],proportion of hypertension and diabetes(52.87%,24.14%),proportion of smoking(16.09%),proportion of family history of CHD(21.84%),proportion of stroke(8.05%),mean platelet volume[(11.847±1.034)fl],platelet distribution width[(16.463±3.090)%],triglyceride[(2.107±0.569)mmol/L],low-density lipoprotein[(4.948±0.846)mmol/L]and total cholesterol[(6.617±0.989)mmol/L]were all significantly elevated,The levels of follicle-stimulating hormone[(2.899±0.288)μg/L],luteinizing hormone[(1.873±0.235)μg/L]and estradiol[(40.777±10.100)pmol/L]were significantly decreased(t=7.478,P<0.001;χ^(2)=34.459,P<0.001;χ^(2)=14.771,P<0.001;χ^(2)=9.429,P=0.002;χ^(2)=25.426,P<0.001;χ^(2)=6.007,P=0.014;t=6.730,P<0.001;t=8.207,P<0.001;t=2.067,P=0.041;t=15.876,P<0.001;t=15.856,P<0.001;t=-95.953,P<0.001;t=-111.451,P<0.001;t=-104.275,P<0.001).The results of binary logistic regression showed that the levels of Body mass index,hypertension,diabetes,smoking,family history of CHD,stroke,mean platelet volume>11fl,platelet distribution width>13%,low density lipoprotein>3.4 mmol/L,follicle-stimulating hormone,luteinizing hormone and estradiol were the influencing factors of coronary atherosclerotic heart disease in perimenopausal women.The receiver opera

关 键 词：围绝经期 冠状动脉粥样硬化性心脏病 危险因素 风险模型 

分 类 号：R711.5[医药卫生—妇产科学]