中青年体检人群颈动脉粥样硬化及相关危险因素

目的 分析中青年体检人群颈动脉粥样硬化检出率及其相关危险因素.方法 2013年4至10月北京协和医院19～59岁的体检者,除外既往有高血压、糖尿病、冠心病、脑血管病、结缔组织疾病者,均接受血压、血糖、血脂和超声颈动脉超声等检查,共入选762名,其中男589名,女173名,平均年龄（46±9）岁.采用t检验计算不同年龄组内（＜40岁、40～49岁、50～59岁）,粥样硬化组和无粥样硬化组间血压、血糖、血脂的差别.对年龄、性别、血压、血糖、血脂等危险因素进行logistic回归分析,将年龄进行受试者工作特征曲线（ROC曲线）分析.结果 男性组颈动脉粥样硬化阳性率30.2％（178/589）,女性组颈动脉粥样硬化阳性率15.6％（27/173）,两组比较差异有统计学意义（χ2=14.522,P=0.000）.在40～49岁人群,有无颈动脉粥样硬化组间的舒张压（74.19±8.96） vs.（71.10±9.71）]差异有统计学意义（t=-2.789,P＜0.05）;有颈动脉粥样硬化组与无粥样硬化组间在＜40岁（5.77±1.59）vs.（5.08±0.94）]、40～49岁（5.43±0.84）vs.（5.19±0.65）]、50～59岁（5.32±0.70） vs.（5.14±9.46）]各组的血糖差异均有统计学意义（t值分别为-2.256,-2.930,-2.174,P＜0.05）.logistic回归分析显示,年龄、性别、舒张压、血糖等4项是中青年健康体检者颈动脉硬化的独立危险因素,回归系数分别为0.993,0.711,0.047,0.334.年龄的ROC曲线下面积为0.731,cut-off值为51岁.结论 对于50岁以上的健康中年男性常规进行颈动脉超声有利于早期明确有无动脉硬化,而对于血糖异常、舒张压升高的人群可能需要更积极地进行这方面的检查.

Analysis of risk factors related with carotid atherosclerotic arteriosclerosis in a Chinese young and middle-aged population who received health checkup

Objective To investigate the relationship between carotid artery atherosclerosis and risk factor in a young and middle-aged population in China who received health checkup.Methods A total of 762 cases of young and middle-aged adult were recruited between April and October in 2013.These subjects had no hypertension,diabetes,coronary heart disease,cerebrovascular disease,and connective tissue disease,etc.Their Blood pressure,serum glucose （Glu）,total cholesterol （TC）,triglyceride （TG）,and low density lipoprotein cholesterol （LDL-C） were measured and carotid artery ultrasonography was performed.Of the 762 cases,589 were male,173 were female,mean age was （46 ± 9） years.For blood pressure,blood lipids,the t test was performed to detect the difference between arteriosclerosis group and non arteriosclerosis group in different age groups.Logistic regression was performed to reveal the risk factors with carotid arteriosclerosis.Results Of the 762 subjects,205 had carotid artery atherosclerosis; 30.2% （178/589） of them were men and 15.6%（27/173） of them were women,with a significant difference between two groups,（χ2=14.522,P=0.000）.In the younger than 40 years old group,the diastolic blood pressure has statistical significance between carotid arteriosclerosis and non carotid arteriosclerosis group （t=-2.789,P〈 0.05）; blood sugar had statistically significant difference between the two groups （t value was-2.256,-2.930,-2.174,respectivly,P〈0.05）.Multiple regression analysis revealed that the independent risk factors for carotid artery arteriosclerosis were age,sex,DBP,and Glu.The regression coefficients were 0.993,0.711,0.047,0.334 seperately.The ROC curve of age was analyzed,the area under the ROC curve was 0.731,cut-off was 51 years old.Conclusions Routine carotid artery ultrasound should be performed for older than 50 healthy middle-aged men,to determine whether arteriosclerosis exists,especially for people with abnormal blood glucose or elevated DBP.