CAJ | 학술논문

目的探讨妊娠高血压综合征( PIH)对妇女远期心脑血管事件的影响.方法采用双向性队列研究设计,选择1976年10月至2008年12月期间在开滦医疗集团住院分娩且参加2006年7月至2007年10月健康体检的4630例妇女组成观察队列.根据是否有PIH史,将人选者分为PIH组(694例)和非PIH组(3936例).随访期间观察研究对象心脑血管事件(包括心肌梗死、脑梗死、脑出血)的发生情况,采用多变量Cox比例风险回归模型分析影响心脑血管事件发生的因素.结果 (1)随访时间为2 ～34(15.3±7.9)年.(2)与非PIH组比较,PIH组妇女生育年龄、分娩前收缩压及舒张压均较高,而孕周及新生儿体质量较低(P均＜ 0.01).健康体检时,PIH组收缩压、舒张压、腰围、体质指数、甘油三酯、总胆固醇及空腹血糖均高于非PIH组(P＜0.05或P＜0.01).(3)随访期间共发生心脑血管事件71例,PIH组心脑血管事件、心肌梗死事件和脑梗死事件累积发病率分别为20.64％、11.08％和8.67％,均高于非PIH组的7.82％、4.02％和2.67％(P均＜0.01).校正其他危险因素后,多变量Cox比例风险回归模型分析显示PIH组发生心脑血管事件、心肌梗死事件和脑梗死事件的危险分别为非PIH组的2.99倍(95％ CI:1.80 ～4.95)、3.91倍(95％CI:1.71 ～8.91)和3.96倍(95％ CI:1.95 ～8.05).结论 PIH妇女远期心脑血管事件、心肌梗死事件及脑梗死事件的累积发病率高于非PIH妇女.PIH是妇女远期缺血性心脑血管事件的独立危险因素.
목적 탐토임신고혈압종합정( PIH)대부녀원기심뇌혈관사건적영향.방법 채용쌍향성대렬연구설계,선택1976년10월지2008년12월기간재개란의료집단주원분면차삼가2006년7월지2007년10월건강체검적4630례부녀조성관찰대렬.근거시부유PIH사,장인선자분위PIH조(694례)화비PIH조(3936례).수방기간관찰연구대상심뇌혈관사건(포괄심기경사、뇌경사、뇌출혈)적발생정황,채용다변량Cox비례풍험회귀모형분석영향심뇌혈관사건발생적인소.결과 (1)수방시간위2 ～34(15.3±7.9)년.(2)여비PIH조비교,PIH조부녀생육년령、분면전수축압급서장압균교고,이잉주급신생인체질량교저(P균＜ 0.01).건강체검시,PIH조수축압、서장압、요위、체질지수、감유삼지、총담고순급공복혈당균고우비PIH조(P＜0.05혹P＜0.01).(3)수방기간공발생심뇌혈관사건71례,PIH조심뇌혈관사건、심기경사사건화뇌경사사건루적발병솔분별위20.64％、11.08％화8.67％,균고우비PIH조적7.82％、4.02％화2.67％(P균＜0.01).교정기타위험인소후,다변량Cox비례풍험회귀모형분석현시PIH조발생심뇌혈관사건、심기경사사건화뇌경사사건적위험분별위비PIH조적2.99배(95％ CI:1.80 ～4.95)、3.91배(95％CI:1.71 ～8.91)화3.96배(95％ CI:1.95 ～8.05).결론 PIH부녀원기심뇌혈관사건、심기경사사건급뇌경사사건적루적발병솔고우비PIH부녀.PIH시부녀원기결혈성심뇌혈관사건적독립위험인소.
Objective To compare the incidence of cardio-cerebral vascular events between pregnancy induced hypertension (PIH) women and non-PIH (NPIH) women.Methods Ambispective cohort study method was used and 4630 pregnant women giving birth during October 1976 to December 2008 in our hospital and participated the healthy examination between July 2006 and October 2007 at Kailuan medical group were included and divided into PIH group ( n =694) and NPIH group ( n =3936) by the history of PIH.Incidence of cardio-cerebral vascular events ( myocardial infarction,cerebral infarction and cerebral hemorrhage ) was obtained during follow-up. Muhivariable Cox proportional hazards regression models was used to assess the relative risk of cardio-cerebral vascular events.Results ( 1 ) The follow-up time was 2 to 34 ( 15.32 ± 7.94)years.(2)The childbearing age,systolic blood pressure and diastolic blood pressure before delivery were significantly higher while gestational weeks and weight of newborn were significantly less in PIH group than in NPIH group ( all P ＜ 0.01 ). Levels of systolic blood pressure,diastolic blood pressure,waist circumference,body mass index,triglyceride,total cholesterol and fasting blood glucose during healthy examination between July 2006 and October 2007 were significantly higher in PIH group than in NPIH group(P ＜ 0.05 or P ＜ 0.01 ). (3) There were 71 cardio-cerebral vascular events during the follow-up. In PIH group,the incidence rate of cardio-cerebral vascular events, myocardial infarction and cerebral infarction was 20.64％,11.08％ and 8.67％,respectively,while the corresponding incidence rate was 7.82％,4.02％ and 2.67％ in NPIH group ( all P ＜0.01 ).After adjustment for other traditional cardiovascular risk factors,the risk of total cardio-cerebral vascular events,myocardial infarction and cerebral infarction in PIH group was 2.99 fold ( 95％ CI:1.80 - 4.95 ),3.91 fold (95％ CI:1.71 -8.91) and 3.96 fold (95％ CI:1.95 - 8.05 ) higher than in NPIH group.Conclusion PIH is an independent risk factor for cardio-cerebral vascular events.