中国循环杂志
中國循環雜誌
중국순배잡지
CHINESE CIRCULATION JOURNAL
2014年
7期
532-536
,共5页
王梦%谢高强%王浩%任福秀%梁立荣%赵连成%杨颖%解武祥%史平%武阳丰
王夢%謝高彊%王浩%任福秀%樑立榮%趙連成%楊穎%解武祥%史平%武暘豐
왕몽%사고강%왕호%임복수%량립영%조련성%양영%해무상%사평%무양봉
颈动脉斑块%缺血性心血管事件%超声检查
頸動脈斑塊%缺血性心血管事件%超聲檢查
경동맥반괴%결혈성심혈관사건%초성검사
Carotid plaque%Ischemic cardiovascular disease%Ultrasonography
目的：探讨最大斑块面积进展速率与新发缺血性心血管事件的关系。<br> 方法：对“中美心血管病和心肺疾病流行病学合作研究”中的石景山人群进行定期颈动脉超声检查、心血管危险因素调查和急性心血管事件的随访。至少接受过两次超声检查且第二次检查前没有发生过心血管事件的1479名研究对象被纳入分析。研究对象按照基线有无斑块等分为5组即对照组（两次检查均无斑块检出）、新发斑块组、斑块逆转组、斑块稳定组和斑块进展组。用Cox比例风险模型估计两次检查间颈动脉最大斑块面积进展速率与第二次检查后新发缺血性心血管事件的比例风险（HR）。<br> 结果：无论是单因素分析还是调整年龄和性别后，当以基线和复查均无斑块即对照组作为参考时，新发斑块组、斑块逆转组、斑块稳定组、斑块进展组发生缺血性心血管事件的风险均显著地高于对照组，风险比依次为3.5，5.7，6.2和7.3；P值均<0.05。风险比逐渐趋势在调整年龄和性别后仍然具有统计学显著性（趋势检验P<0.001）。<br> 结论：最大斑块面积进展速率可预测缺血性心血管事件的风险，该结果支持斑块面积指标作为风险评估和疗效评价的工具用于临床实践。
目的：探討最大斑塊麵積進展速率與新髮缺血性心血管事件的關繫。<br> 方法：對“中美心血管病和心肺疾病流行病學閤作研究”中的石景山人群進行定期頸動脈超聲檢查、心血管危險因素調查和急性心血管事件的隨訪。至少接受過兩次超聲檢查且第二次檢查前沒有髮生過心血管事件的1479名研究對象被納入分析。研究對象按照基線有無斑塊等分為5組即對照組（兩次檢查均無斑塊檢齣）、新髮斑塊組、斑塊逆轉組、斑塊穩定組和斑塊進展組。用Cox比例風險模型估計兩次檢查間頸動脈最大斑塊麵積進展速率與第二次檢查後新髮缺血性心血管事件的比例風險（HR）。<br> 結果：無論是單因素分析還是調整年齡和性彆後，噹以基線和複查均無斑塊即對照組作為參攷時，新髮斑塊組、斑塊逆轉組、斑塊穩定組、斑塊進展組髮生缺血性心血管事件的風險均顯著地高于對照組，風險比依次為3.5，5.7，6.2和7.3；P值均<0.05。風險比逐漸趨勢在調整年齡和性彆後仍然具有統計學顯著性（趨勢檢驗P<0.001）。<br> 結論：最大斑塊麵積進展速率可預測缺血性心血管事件的風險，該結果支持斑塊麵積指標作為風險評估和療效評價的工具用于臨床實踐。
목적：탐토최대반괴면적진전속솔여신발결혈성심혈관사건적관계。<br> 방법：대“중미심혈관병화심폐질병류행병학합작연구”중적석경산인군진행정기경동맥초성검사、심혈관위험인소조사화급성심혈관사건적수방。지소접수과량차초성검사차제이차검사전몰유발생과심혈관사건적1479명연구대상피납입분석。연구대상안조기선유무반괴등분위5조즉대조조（량차검사균무반괴검출）、신발반괴조、반괴역전조、반괴은정조화반괴진전조。용Cox비례풍험모형고계량차검사간경동맥최대반괴면적진전속솔여제이차검사후신발결혈성심혈관사건적비례풍험（HR）。<br> 결과：무론시단인소분석환시조정년령화성별후，당이기선화복사균무반괴즉대조조작위삼고시，신발반괴조、반괴역전조、반괴은정조、반괴진전조발생결혈성심혈관사건적풍험균현저지고우대조조，풍험비의차위3.5，5.7，6.2화7.3；P치균<0.05。풍험비축점추세재조정년령화성별후잉연구유통계학현저성（추세검험P<0.001）。<br> 결론：최대반괴면적진전속솔가예측결혈성심혈관사건적풍험，해결과지지반괴면적지표작위풍험평고화료효평개적공구용우림상실천。
Objective: To explore the progression rate of cortid maximal plaque area and the risk of new ischemic cardiovascular disease (ICVD) in a rural cohort in Beijing. <br> Methods: The PRC-USA collaborative study had been regularly conducted in Shijingshan area in Beijing. The carotid ultrasound examination, ICVD risk factor and acute cardiovascular events follow-up were conducted in those participants. A total of 1479 subjects who received at least 2 carotid ultrasound examinations and had no cardiovascular disease before the second ultrasound were studied. They were divided into 5 groups:①Control group, the participants had no plaque detected by 2 ultrasounds; ② New plaque group, new plaque was found at the second ultrasound examination; ③ Plaque regression group; ④ Plaque stabilized group and ⑤ Plaque progression group. The hazard ratio (HR) between the progression rate of corotid maximal plaque area and new ICVD events was estimated by Cox proportional hazard regression analysis . <br> Results: Compared with Control group, the HR for new ICVD events were higher in groups②,③,④and⑤at 3.5, 5.7, 6.2 and 7.3 respectively, all P<0.05. The increasing trend of HRs remained signiifcant with the adjusted age and gender, P<0.001. <br> Conclusion: The progression rate of maximal corot id plaque area rate could predict the risk of new ICVD events in clinical practice.
