江苏省心血管病高危人群颈动脉斑块流行及影响因素分析

毕媛; 覃玉; 苏健; 崔岚; 杜文聪; 缪伟刚; 李晓波; 周金意

文章摘要

毕媛,覃玉,苏健,崔岚,杜文聪,缪伟刚,李晓波,周金意.江苏省心血管病高危人群颈动脉斑块流行及影响因素分析[J].中华流行病学杂志,2019,40(11):1432-1438

江苏省心血管病高危人群颈动脉斑块流行及影响因素分析

Prevalence and influencing factors of carotid plaque in population at high-risk for cardiovascular disease in Jiangsu province

收稿日期:2019-04-04 出版日期:2019-11-26

DOI：10.3760/cma.j.issn.0254-6450.2019.11.017

中文关键词: 颈动脉斑块心血管病危险因素

英文关键词: Carotid plaque Cardiovascular disease Risk factors

基金项目:中央财政转移支付地方卫生计生服务项目

作者	单位	E-mail
毕媛	东南大学公共卫生学院, 南京 210009
覃玉	江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009
苏健	江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009
崔岚	江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009
杜文聪	江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009
缪伟刚	江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009
李晓波	东南大学公共卫生学院, 南京 210009	101011116@seu.edu.cn
周金意	江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009	zhoujinyi74@sina.com

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中文摘要:

目的了解颈动脉斑块（CP）在江苏省心血管病高危人群中的流行概况及相关影响因素。方法 2015-2016年依托中国心血管病高危人群早期筛查与综合干预项目，以江苏省6个项目点筛查出的11 392名心血管病高危人群作为研究对象，进行问卷调查、身体测量、实验室检测以及颈动脉彩色超声检测，探讨CP的流行概况，对CP发生的影响因素进行多因素logistic回归分析。结果研究对象年龄为（59.4±8.9）岁，男性4 821例（42.3%）。颈动脉异常5 971例（52.4%），其中颈动脉内中膜增厚1 782例（15.6%），CP 3 811例（33.5%），颈动脉狭窄378例（3.3%）。高龄（OR=2.253，95%CI：2.127~2.386）、城市居民（OR=2.622，95%CI：2.375~2.895）、高血压（OR=1.439，95%CI：1.195~1.732）、吸烟（OR=1.441，95%CI：1.259~1.650）、脉压差增大（OR=1.270，95%CI：1.198~1.347）、FPG升高（OR=1.109，95%CI：1.059~1.161）、LDL-C/HDL-C升高（OR=1.225，95%CI：1.164~1.288）增加心血管病高危人群发生CP的风险，女性（OR=0.558，95%CI：0.494~0.630）、高BMI（OR=0.948，95%CI：0.904~0.994）、较高的文化程度（OR=0.708，95%CI：0.531~0.945）和较高的家庭年收入（OR=0.773，95%CI：0.669~0.894）则降低其风险。结论江苏省超一半心血管病高危人群颈动脉异常，高血压、高血糖、高血脂和吸烟是相关影响因素。

英文摘要:

Objective To understand the prevalence of carotid plaque (CP) in population at high-risk for cardiovascular disease (CVD) in Jiangsu province and identify related influencing factors. Methods Based on the China Patient-centered Evaluative Assessment of Cardiac Events Million Persons Project from 2015 to 2016, a total of 11 392 persons at high-risk for CVD were selected from six project areas in Jiangsu province for the questionnaire survey, physical measurement, laboratory test and bilateral ultrasound examination of carotid arteries. The prevalence of CP and influencing factors of abnormal carotid arteries, CP and plaque burden (CP ≥ 2) were analyzed. Results Among the persons surveyed, 4 821 (42.3%) were males. The age of the persons surveyed was (59.4±8.9) years. There were 5 971 abnormal carotid arteries cases (52.4%), including 1 782 carotid intima-media thickness thickening cases (15.6%), 3 811 CP cases (33.5%) and 378 carotid stenosis cases (3.3%). Older age (OR=2.253, 95%CI:2.127-2.386), urban residence (OR=2.622, 95%CI:2.375-2.895), hypertension (OR=1.439, 95%CI:1.195-1.732), smoking (OR=1.441, 95%CI:1.259-1.650), pulse pressure difference (OR=1.270, 95%CI:1.198-1.347), fasting plasma glucose (FPG) (OR=1.109, 95%CI:1.059-1.161) and LDL-C/HDL-C (OR=1.225, 95%CI:1.164-1.288) were possible risk factors of CP in population at high risk for CVD. Being women (OR=0.558, 95%CI:0.494-0.630), high BMI (OR=0.948, 95%CI:0.904-0.994), higher levels of education (OR=0.708, 95%CI:0.531-0.945), and higher annual household income (OR=0.773, 95%CI:0.669-0.894) were the possible protective factors. Conclusions Over half of the population at high-risk for CVD in Jiangsu showed abnormal carotid arteries. High blood pressure, high blood glucose, high blood lipids and smoking were the main factors that could be changed.

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