金昌队列职业人群颈动脉粥样硬化发病情况及其与脑卒中发病关联  

Incidence of carotid atherosclerosis and association of carotid athero-sclerosis with stroke incidence among the occupational population in China:an analysis of data from the Jinchang Cohort Study

作　　者：吕康 张晓飞 刘少东 王雪 罗妍 王敏珍[1] 尹春 白亚娜[1] 郑山[1] LU Kang;ZHANG Xiaofei;LIU Shaodong;WANG Xue;LUO Yan;WANG Minzhen;YIN Chun;BAI Yana;ZHENG Shan(Institute of Epidemiology and Health Statistics,School of Public Health,Lanzhou University,Lanzhou 730000,China;Yanta District Center for Disease Control and Prevention,Xi'an 710000,China;Department of Cardiovascular Medicine,Workers Hospital of Jinchuan Group Co.,Ltd.,Jinchang 737100,China)

机构地区：[1]兰州大学公共卫生学院流行病与卫生统计学系,兰州730000 [2]西安市雁塔区疾病预防控制中心,西安710000 [3]金川集团有限公司职工医院心血管内科,金昌737100

出　　处：《中国公共卫生》2024年第6期666-673,共8页Chinese Journal of Public Health

基　　金：兰州大学中央高校基本科研业务费专项资金(lzujbky-2018-69)。

摘　　要：目的了解金昌队列职业人群颈动脉粥样硬化(CAS)发病情况及其与脑卒中发病的关系,为CAS及脑卒中的防治提供科学依据。方法依托金昌队列平台抽取2011年6月—2013年12月完成基线调查并进行颈部彩色多普勒超声检查且信息完整的职业人群为研究对象,并分别匹配2015年和2017年完成的第1期及第2期随访信息,在排除不合格对象后最终纳入6262名职业人群计算其CAS和脑卒中的累积发病率,应用多因素非条件logistic回归模型分析CAS、颈动脉内-中膜增厚和颈动脉硬化斑块发生的影响因素,并应用多因素Cox比例风险回归模型分析CAS、颈动脉内-中膜增厚和颈动脉硬化斑块者的脑卒中发病风险及发生脑卒中的影响因素。结果金昌队列职业人群第1期随访0.08~3.75年,平均随访(1.71±0.55)年;共发生CAS者1147例,累积发病率为18.32%,其中发生颈动脉内-中膜增厚者和颈动脉硬化斑块者分别为287例和860例,累积发病率分别为4.58%和13.73%。多因素非条件logistic回归分析结果显示,年龄≥45岁、目前仍吸烟、高血压、糖尿病、总胆固醇(TC)异常、职业为干部或技术人员和内勤人员是金昌队列职业人群发生CAS的危险因素,大专及以上文化程度是金昌队列职业人群发生CAS的保护因素;年龄≥45岁、职业为干部或技术人员、目前仍吸烟、高糖饮食和高血压是金昌队列职业人群发生颈动脉内-中膜增厚的危险因素,女性是金昌队列职业人群发生颈动脉内-中膜增厚的保护因素;女性、年龄≥45岁、职业为内勤人员、高血压、糖尿病和TC异常是金昌队列职业人群发生颈动脉硬化斑块的危险因素,大专及以上文化程度是金昌队列职业人群发生颈动脉硬化斑块的保护因素。金昌队列职业人群第2期随访0.06~4.37年,平均随访(2.67±0.55)年;共发生脑卒中者240例,累积发病率为3.83%,其中CAS、颈动脉内-中膜增厚和颈动脉硬�Objective To understand the incidence of carotid atherosclerosis(CAS)and the association of CAS with stroke incidence in an occupational population of the Jinchang Cohort,and to provide an evidence for the prevention and treatment of CAS and stroke.Methods The analysis included 6262 employees of a nonferrous metal company who participated in the Jinchang Cohort Study and had complete information from the baseline examination,including carotid color Doppler ultrasound,from June 2011 to December 2013 and two rounds of follow-up in 2015 and 2017.The cumulative incidence rates of CAS,carotid intima-media thickening,carotid atherosclerotic plaque,and stroke were calculated among the employees during the follow-up period.A multivariate unconditional logistic regression model was used to analyze the factors associated with CAS,carotid intima-media thickening,and carotid atherosclerotic plaque.A multivariate Cox proportional hazards regression model was used to analyze the risk of stroke incidence and its influencing factors in individuals with CAS,carotid intima-media thickening,and carotid atherosclerotic plaque.Results During the initial follow-up of a mean of 1.71±0.55 years(ranging from 0.08 to 3.75 years),a total of 1147 cases of CAS,287 cases of carotid intima-media thickening,and 860 cases of carotid atherosclerotic plaque were observed,with cumulative incidence rates of 18.32%,4.58%,and 13.73%,respectively.The results of multivariate unconditional logistic regression analysis showed that age≥45 years,smoking,hypertension,diabetes,abnormal total cholesterol(TC),working as a cadre or technical personnel,and internal staff were risk factors for CAS in the occupational population;whereas education level of college or above was a protective factor;age≥45 years,working as a cadre or technical personnel,smoking,having high-sugar diet,and hypertension were risk factors for carotid intima-media thickening,whereas female gender was a protective factor;females,age≥45 years,working as internal staff,hypertension,diab

关 键 词：颈动脉粥样硬化(CAS) 脑卒中 发病 关系 职业人群 金昌队列 

分 类 号：R743.3[医药卫生—神经病学与精神病学]