1214例心血管住院患者颈动脉内膜中膜增厚相关因素分析
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Related Factors for Increased Carotid Intima-Media Thickness of 1214 Cardiovascular Inpatients
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    摘要:

    目的 分析颈动脉内膜中膜厚度(IMT)增厚的危险因素。方法 收集我院心内科住院患者1214例,根据高频超声检测IMT,以IMT≤1.0 mm及>1.0 mm分成IMT正常和 IMT增厚两组。比较两组性别、年龄、吸烟、高血压病、2型糖尿病、收缩压、脉压、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、总胆汁酸(TBA)、尿酸(UA)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、空腹血糖(FBG)、D-二聚体的差异。对有差异的因素进行Logistic回归分析其与IMT之间的关系。结果 ①与IMT正常组比较,IMT增厚组男性、吸烟、高血压病、2型糖尿病比例升高,收缩压、脉压、UA、DBIL、LDLC、FBG、D-二聚体值升高,年龄大,TBA值降低,差异有统计学意义(P<0.05)。TBIL、IBIL、TG、TC、HDLC在两组间差异没有统计学意义(P<0.05)。②逐步Logistic回归分析提示吸烟、年龄、LDLC、DBIL、FBG、收缩压、D-二聚体等为主要因素与IMT增厚呈正相关,其优势比(OR)为吸烟2.904(95%CI:2.050~4.113)、LDLC 1.838(95%CI:1.534~2.202)、年龄1.137(95%CI:1.118~1.157)、FBG 1.072(95%CI:1.008~1.140)、收缩压1.011(95%CI:1.005~1.018)、DBIL 1.093(95%CI:1.015~1.176)、D-二聚体1.455(95%CI:1.187~1.785)。结论 吸烟、年龄增大、LDLC、D-二聚体、DBIL、FBG、收缩压升高是IMT增厚的主要危险因素。由于入选人群为心血管住院患者,研究结果具有一定的局限性,有待多中心前瞻性研究确证。

    Abstract:

    Aim To analyse the risk factors of patients with carotid intima-media thickness. Methods 1214 patients collected from the ward of cardiology were assigned into two groups according to the IMT thickness by high-frequency ultrasound. IMT≤1.0 mm was classified as normal IMT group, IMT>1.0 mm classified as IMT thickening group. The difference of gender, age, smoking, hypertension, type 2 diabetes, systolic blood pressure, total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), bile acid (TBA), uric acid (UA), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDLC), low density lipoprotein (LDLC), fasting blood glucose (FBG), D-dimer between the two groups was compared. Logistic regression analysis was used to analyse the relationship of the IMT and the different factors of the two groups. Results ①The proportion of male, smoking, hypertension, type 2 diabete and the factors of systolic blood pressure, pulse pressure, UA, DBIL, LDLC, FBG, D-dimer of IMT thickening group was higher than the normal group. The age of IMT thickening group was older than the normal group. The TBA of IMT thickening group was lower than the normal group. Those differences were statistically significant(P<0.05). But the differences of TBIL,IBIL,TG,TC,HDLC between the two groups was not statistically significant(P<0.05). ②Stepwise Logistic regression analysis showed that smoking, age, LDLC, DBIL, FBG, SBP, D-dimer as the main factors were positively correlated with IMT thickening and its odds ratio (OR): smoking 2.904(95%CI: 2.050~4.113), LDLC 1.838 (95%CI:1.534~2.202), age 1.137(95%CI:1.118~1.157), FBG 1.072(95%CI:1.008~1.140), systolic blood pressure 1.011(95%CI:1.005~1.018), DBIL 1.093(95%CI:1.015~1.176), D-dimer 1.455(95%CI:1.187~1.785). Conclusions Smoking, high LDLC, old age, high FBG, elevated systolic blood pressure, high DBIL, high D-dimer are major risk factors for IMT thickening. The foundings have some limitations for cardiovascular patients enrolled,which should be confirmed by multi-center prospective studies.

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张和细,龚 辉.1214例心血管住院患者颈动脉内膜中膜增厚相关因素分析[J].中国动脉硬化杂志,2014,22(02):173~177.

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  • 收稿日期:2013-08-29
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