中老年人群颈动脉粥样硬化分布特点及影响因素分析

目的 探讨我国中老年人群颈动脉粥样硬化性病变的分布特点以及与心血管病危险因素的关系.方法 对中美协作研究队列中的石景山人群和多省市队列中的北京大学社区人群2007年9至10月期间的心血管病危险因素以及颈动脉超声的横断面复查结果进行分析.参加调查人数共计2681名,年龄43～81岁.结果 (1)颈动脉内中膜36点厚度平均值为0.68 mm,最大值为1.07 mm.(2)颈动脉斑块检出率为60.3%.男女两性颈动脉膨大部斑块检出率分别为61.2%和51.6%(x~2=23.44,P<0.01).颈内动脉斑块检出率分别为24.7%和12.2%(x~2=69.57,P<0.01).颈总动脉斑块检出率分别为20.9%和13.8%(x~2=23.18,P<0.01).(3)多因素分析:男女两性颈动脉内中膜厚度平均值和最大值随着收缩压、血糖及低密度脂蛋白胆固醇水平的增加而增加.与无危险因素者比较,高血压、糖尿病、吸烟和高低密度脂蛋白胆固醇血症者颈动脉斑块检出率较高(P<0.05).结论 我国中老年人群颈动脉粥样硬化普遍存在,且与多个心血管病危险因素有关联.

Distribution characteristics and risk factors of carotid atherosclerosis in middle-aged and elderly Chinese

Objective To describe the distribution characteristics of carotid atherosclerosis and to analyze its association with cardiovascular risk factors in middle-aged and elderly Chinese. Methods In 2007, the second cross-sectional examination for cardiovascular risk factors and B-mode ultrasound imaging on carotid arteries were performed in a Chinese population consisting of 2681 subjects aged 43-81 years old from two cohorts participants of the People's Republic of China/United States of America collaborative study (USA-PRC study) and the Chinese multi-provincial cohort study (CMCS). The association of cardiovascular risk factors with intima-media thickening (ITM) and plaque of carotid arteries was analyzed. Results ( 1 )The mean intima-media thickening (Mean-IMT) of carotid artery was 0. 68 mm, the maximal intima-media thickening (Max-IMT) was 1.07 mm. (2)The prevalence rate of carotid plaque was 60. 3% in all subjects.As for the different sites of carotid arteries, the plaque prevalence rate at carotid bulb was 61.2% for male and 51.6% for female( x~2 = 23.44 ,P <0. 01 ), and at the internal carotid artery was 24. 7% for male and 12. 2% for female( x~2 =69.57 ,P <0. 01 ) ,at the common carotid artery was 20. 9% for male and 13.8% for female(x~2 =23.18,P<0. 01 ). (3)After adjusting for age and other cardiovascular risk factors, the MeanIMT and Max-IMT increased with elevated levels of systolic blood pressure, plasma glucose and low density lipoproteins cholesterol (LDL-C)( all P < 0. 05 ). Hypertension, diabetes, smoking and high LDL-C (P <0. 05 ) were independent predict factors for the risk of carotid plaque. Conclusion The carotid atherosclerosis was common in middle and older age Chinese and was positively associated with classical cardiovascular disease risk factors.