常规体检指标对颈动脉硬化发生的预测价值  

The Predictive Value of Routine Physical Examination Indicators for the Occurrence of Carotid Atherosclerosis

作　　者：武艳[1] 高世超 张洁[1] 闫国超[1] 李素华[1] 金素丽 WU Yan;GAO Shichao;ZHANG Jie;YAN Guochao;LI Suhua;JIN Suli(Department of Clinical Laboratory,the First Hospital of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院检验中心,河北石家庄050031

出　　处：《标记免疫分析与临床》2024年第4期647-652,共6页Labeled Immunoassays and Clinical Medicine

基　　金：河北省卫生健康委医学科学研究课题计划项目(编号:20190433)。

摘　　要：目的探讨常规体检指标如性别、年龄、血压、血脂、同型半胱氨酸等在颈动脉硬化发生的预测价值。方法采用回顾性研究方法。选取2016年1月至2021年12月连续6年在我院接受健康体检人群985例作为研究对象。收集受试者一般资料、体格检查指标、实验室检查指标、颈动脉超声结果等信息。受试者在随访中经颈动脉超声诊断为颈动脉内中膜厚度(cIMT)>1mm或有颈动脉斑块形成则被认为出现颈动脉粥样硬化进展并结束随访。受试者若未出现颈动脉粥样硬化进展,则直至2021年12月随访结束。将研究对象按随访过程中cIMT是否增加分为硬化组、进展组和对照组。分析颈动脉硬化发生的影响因素,并采用受试者操作特征曲线分析体检指标对颈动脉硬化的诊断效能。结果进展组在颈动脉硬化发病后TC、LDL-C、FBG、UA、Hcy和SBP均高于发生前,HDL-C低于发病前,差异有统计学意义(P<0.05);硬化组除HDL-C和Hcy指标差异没有统计学意义外,其他指标如男性比例、年龄、TC、TG、LDL-C、FBG、UA、SBP、DBP、BMI指标均高于对照组,差异有统计学意义(P<0.05);其中FBG、LDL-C和SBP为颈动脉硬化发生的独立风险因素(OR=5.505、4.222、1.071,P<0.05),以上指标联合诊断颈动脉硬化的曲线下面积高于各项单独检测,差异有统计学意义(P<0.01)。结论FBG、LDL-C和BMP与颈动脉硬化的发生密切相关,联合检测对颈动脉硬化有较好的诊断效能。Objective To explore the predictive value of routine physical examination indicators,such as gender,age,blood pressure,blood lipids,and homocysteine in the occurrence of carotid atherosclerosis.Methods A retrospective cohort study method was applied for this analysis.985 individuals who underwent health examinations in our hospital for 6 consecutive years from January,2016 to December,2021 were selected as the research subjects.We collected general information,physical examination indicators,laboratory examination indicators,carotid ultrasound results,and other information from these subjects.During follow-up,if the subjects were diagnosed with carotid intima-media thickness(cIMT)>1 mm or carotid plaque formation by carotid ultrasound,they were considered to have carotid atherosclerosis progression and the follow-up ended.If there was no progression of carotid atherosclerosis,those subjects were followed up until December 2021.We divided the study subjects into the sclerosis group,progression group,and control group based on whether cIMT increased during follow-up.We then analyzed the influencing factors of carotid atherosclerosis occurrence and used subject operating characteristic curves to evaluate the diagnostic efficacy of physical examination indicators for carotid atherosclerosis.Results In the progression group,TC,LDL-C,FBG,UA,Hcy and SBP were higher than before the onset of carotid atherosclerosis,while HDL-C was lower than before the onset,with statistical significance(P<0.05);The sclerosis group had no statistically significant differences in HDL-C and Hcy indicators,while other indicators,such as male proportion,age,TC,TG,LDL-C,FBG,UA,SBP,DBP and BMI,were higher than the control group,with statistical significance(P<0.05);Among them,FBG,LDL-C,and SBP were independent risk factors for the occurrence of carotid atherosclerosis(OR=5.505,4.222,1.071,P<0.05).The area under the curve for the combined diagnosis of carotid atherosclerosis was higher than that of individual tests,and the difference was statist

关 键 词：颈动脉硬化 颈动脉内中膜厚度 低密度脂蛋白胆固醇(LDL-C) 空腹血糖 收缩压 

分 类 号：R543[医药卫生—心血管疾病]