体检人群颈动脉粥样硬化筛查及危险因素分析

Investigation on carotid atherosclerosis and risk factors in normal physical examination crowd

摘要:

目的 探讨正常人群颈动脉粥样硬化（CAS）的流行情况及危险因素。方法 选取2017 年1 月— 2017 年12 月在中南大学湘雅医院进行健康体检的6 238 例体检人群作为研究对象。根据颈动脉超声结果将 体检人群分为CAS 组和对照组。对两组收缩压（SBP）、舒张压（DBP）、空腹血糖（FBG）、总胆固醇（TC）、 低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）及甘油三脂（TG）进行检测，以及对相 关因素进行Logistic 回归分析。结果 6 238 例体检者检出1595 例CAS，患病率为25.57%。CAS 患病率随年 龄增长呈上升趋势，男性患病率高于女性（33.31% vs 14.16%）。CAS 组与对照组年龄、体重指数、SBP、TG、 TC、LDL-C、HDL-C、吸烟史及运动情况比较，差异有统计学意义（P <0.05）。Logistic 回归分析显示， LDL-C[Ol ^ R=8.797（95% CI：5.211，19.467）]、性别[Ol ^ R=1.241（95% CI：1.045，0.985）]、年龄[Ol ^ R=5.235（95% CI ：2.321，15.675）] 及SBP[Ol ^ R=4.845（95% CI ：2.156，10.954）] 为CAS 的独立危险因素。结论 正常人 群CAS 患病率较高，应常规筛查CAS 并积极干预危险因素，以减少心脑血管疾病的发病率。

Abstract:

Objective To study the prevalence states and hazards of carotid atherosclerosis (CAS) in normal population. Methods A total of 6238 clients for physical examination were selected as the study subjects from January 2017 to December 2017. They were divided as two categories: CAS group and control group, according to the results of carotid ultrasound. SBP, DBP, fasting blood glucose (FBG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were investigated in the two groups. Logistic regression analysis was carried out for related factors. Results The relevance ratio of CAS in the clients was 25.57 %, and the prevalence rate of CAS increased with age. The detection rate of CAS in male was higher than that in female (33.31% VS 14.16%). There were statistically significant differences in the gender, age, BMI, SBP, TC, TG, LDL-C and HDL-C, the rate of smoking and exercise situation between the two groups (P < 0.05). The multiple logistic aggression analysis indicated that LDL-C [Ol ^ R=8.797, (95% CI: 5.211, 19.467)], gender [Ol ^ R=1.241, (95% CI: 1.045, 0.985)], age [Ol ^ R=5.235, (95% CI: 2.321, 15.675)] and SBP [Ol ^ R=4.845, (95%CI: 2.156, 10.954)] were independent risk factors for CAS. Conclusions The prevalence of CAS was high in normal population. We should routinely screen for CAS and actively intervene in the risk factors to reduce the incidence of cardiovascular and cerebrovascular diseases.