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连云港农村社区中老年高血压人群颈动脉内膜—中膜厚度及斑块的流行病学研究

发布时间:2019-01-09 15:30  文章来源:笔耕文化传播
【摘要】: 摘要目的探讨连云港农村社区中老年高血压患者动脉粥样硬化的发生现状及其与血压、血糖、胆固醇和吸烟的关系。方法从2008年10月至2009年6月,采用流行病学现况调查方法,用区组随机抽取连云港社区45~75岁原发性高血压患者进行临床流行病学调查,采用标准操作规程进行血压测量,全自动生化分析酶法检测总胆固醇(total cholesterol, TC)。由专门接受培训的人员用同一台彩色超声仪器对对象的颈动脉内膜-中膜厚度(CIMT)和斑块进行检查,由经过统一培训的专门人员进行的问卷调查获取流行病学资料。对各项指标进行单因素和多因素分析。结果本研究共纳入对象1346人,其中男585人,女761人。平均年龄男性59.88±7.65岁,女性58.59±7.32岁。CIMT平均厚度男性0.72±0.14mm,女性0.70±0.14mm。斑块检出率男性49.1%,女性32.5%。收缩压平均水平男性167.91±20.84mmHg ,女性169.69±20.99mmHg。舒张压平均水平男性98.02±12.27mmHg,女性94.56±12.23mmHg。总胆固醇男性5.26±1.15mmol/L,女性5.47mmol/L。男性从不吸烟30.8%,现在吸烟51.7%。女性从不吸烟94.6%,现在吸烟2.9%。收缩压与CIMT呈现正相关,随高血压分级升高,检出斑块的风险增加。空腹血糖与CIMT之间不是线性关系。但空腹血糖≥7.0mmol/L的患者检出2个以上斑块的风险显著升高。总胆固醇在男性研究对象中与CIMT呈现正相关,总胆固醇≥5.69mmol/L时CIMT明显增厚,检出CIMT0.8mm的风险显著上升。而女性总胆固醇与CIMT无线性关系,但总胆固醇≥5.69mmol/L时,检出患颈动脉斑块的风险显著升高。CIMT与吸烟呈现正相关,从不吸烟、曾经吸烟和现在吸烟的对象CIMT厚度依次递增。且现在吸烟的患者检出斑块的风险升高。结论连云港社区中老年高血压人群中有较高的动脉粥样硬化患病率,其CIMT厚度与收缩压呈正相关。空腹血糖超过7.0mmol/L或总胆固醇超过5.69mmol/L的高血压患者发生动脉硬化的风险增加。男性吸烟者的动脉硬化风险亦增加。
[Abstract]:Objective to investigate the prevalence of atherosclerosis and its relationship with blood pressure, blood glucose, cholesterol and smoking in elderly hypertensive patients in Lianyungang rural community. Methods from October 2008 to June 2009, the patients with essential hypertension aged 4575 years old in Lianyungang community were randomly selected for clinical epidemiological investigation, and the blood pressure was measured by standard operating procedure. Detection of total cholesterol (total cholesterol, TC). By automatic biochemical analysis enzymatic method The carotid intima-media thickness (CIMT) and plaque were examined with the same color ultrasound instrument, and the epidemiological data were obtained by questionnaire. Single factor and multi-factor analysis were carried out on each index. Results A total of 1346 subjects were included in this study, including 585 males and 761 females. The mean age of CIMT was 59.88 卤7.65 years old in male and 58.59 卤7.32 years old in female. The mean thickness of CIMT was 0.72 卤0.14 mm in male and 0.70 卤0.14 mm in female. The plaque detection rate was 49.1% in men and 32.5% in women. The mean systolic blood pressure was 167.91 卤20.84mmHg in males and 169.69 卤20.99mm Hg in females. The mean diastolic blood pressure was 98.02 卤12.27mmHg in males and 94.56 卤12.23mmHg in females. Total cholesterol was 5.26 卤1.15 mmol / L in men and 5.47 mmol / L in women. Men never smoke 30.8 and now smoke 51.7. Women never smoke 94. 6 and now smoke 2. 9. Systolic blood pressure (SBP) was positively correlated with CIMT, and the risk of plaque detection increased with hypertension grading. The relationship between fasting blood glucose and CIMT is not linear. But the risk of more than 2 plaques in patients with fasting blood glucose 鈮,

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