中华健康管理学杂志
中華健康管理學雜誌
중화건강관이학잡지
CHINESE JOURNAL OF HEALTH MANAGEMENT
2013年
1期
22-26
,共5页
张朔瑒%盖鲁粤%李岩%盖兢泾
張朔瑒%蓋魯粵%李巖%蓋兢涇
장삭창%개로월%리암%개긍경
颈动脉%危险因素%体格检查
頸動脈%危險因素%體格檢查
경동맥%위험인소%체격검사
Carotid arteries%Risk factors%Physical examination
目的 研究健康查体人群中冠状动脉斑块与危险因素的相关性.方法 连续选取2010年1月1日至2011年4月1日期间住院行健康查体且接受了冠状动脉CT的个体604例.以分数的第3个四分值为界,将查体患者分为冠状动脉正常组(评分=0)、轻度病变组(0＜评分≤5)和中重度病变组(评分＞5),使用x2或秩和检验在组间比较5项体格检查、124项实验室检查、21项超声检查和出院诊断等数据.此外还把这些数据直接与冠状动脉评分进行二元相关分析.筛选出组间比较或二元相关有统计学意义的项目带入多元线性回归和二元逻辑回归,找出冠状动脉病变的主要危险因素,并绘制ROC曲线,分析其诊断冠状动脉中重度病变的价值.结果 240例冠状动脉CT未见明显异常,271例有轻度病变,93例有中重度病变.平均颈动脉中-内膜厚度(cIMT)、男性、LDL-C、年龄和HDL-C进入了多元线性回归方程,其中年龄对冠状动脉积分的贡献最大(标准回归系数(β)=0.263),其次为cIMT((β) =0.182).二元逻辑回归和ROC曲线显示,平均cIMT为冠状动脉病变的最强危险因子(OR=7.19、95％CI:2.00 ～ 25.93),其预测冠状动脉中重度病变的价值较大(ROC=0.730、P=0.00、95％CI:0.68 ～0.78),但不能帮助区分轻度病变和正常冠状动脉.此外,冠状动脉斑块多分布在前降支(20.8％),性质以软斑块为主(42.5％).结论 60.2％的健康查体者被CCTA发现了冠状动脉斑块.cIMT、年龄、LDL-C和HDL-C可以较好地预测冠状动脉中重度病变,但和轻度病变关系不大.
目的 研究健康查體人群中冠狀動脈斑塊與危險因素的相關性.方法 連續選取2010年1月1日至2011年4月1日期間住院行健康查體且接受瞭冠狀動脈CT的箇體604例.以分數的第3箇四分值為界,將查體患者分為冠狀動脈正常組(評分=0)、輕度病變組(0＜評分≤5)和中重度病變組(評分＞5),使用x2或秩和檢驗在組間比較5項體格檢查、124項實驗室檢查、21項超聲檢查和齣院診斷等數據.此外還把這些數據直接與冠狀動脈評分進行二元相關分析.篩選齣組間比較或二元相關有統計學意義的項目帶入多元線性迴歸和二元邏輯迴歸,找齣冠狀動脈病變的主要危險因素,併繪製ROC麯線,分析其診斷冠狀動脈中重度病變的價值.結果 240例冠狀動脈CT未見明顯異常,271例有輕度病變,93例有中重度病變.平均頸動脈中-內膜厚度(cIMT)、男性、LDL-C、年齡和HDL-C進入瞭多元線性迴歸方程,其中年齡對冠狀動脈積分的貢獻最大(標準迴歸繫數(β)=0.263),其次為cIMT((β) =0.182).二元邏輯迴歸和ROC麯線顯示,平均cIMT為冠狀動脈病變的最彊危險因子(OR=7.19、95％CI:2.00 ～ 25.93),其預測冠狀動脈中重度病變的價值較大(ROC=0.730、P=0.00、95％CI:0.68 ～0.78),但不能幫助區分輕度病變和正常冠狀動脈.此外,冠狀動脈斑塊多分佈在前降支(20.8％),性質以軟斑塊為主(42.5％).結論 60.2％的健康查體者被CCTA髮現瞭冠狀動脈斑塊.cIMT、年齡、LDL-C和HDL-C可以較好地預測冠狀動脈中重度病變,但和輕度病變關繫不大.
목적 연구건강사체인군중관상동맥반괴여위험인소적상관성.방법 련속선취2010년1월1일지2011년4월1일기간주원행건강사체차접수료관상동맥CT적개체604례.이분수적제3개사분치위계,장사체환자분위관상동맥정상조(평분=0)、경도병변조(0＜평분≤5)화중중도병변조(평분＞5),사용x2혹질화검험재조간비교5항체격검사、124항실험실검사、21항초성검사화출원진단등수거.차외환파저사수거직접여관상동맥평분진행이원상관분석.사선출조간비교혹이원상관유통계학의의적항목대입다원선성회귀화이원라집회귀,조출관상동맥병변적주요위험인소,병회제ROC곡선,분석기진단관상동맥중중도병변적개치.결과 240례관상동맥CT미견명현이상,271례유경도병변,93례유중중도병변.평균경동맥중-내막후도(cIMT)、남성、LDL-C、년령화HDL-C진입료다원선성회귀방정,기중년령대관상동맥적분적공헌최대(표준회귀계수(β)=0.263),기차위cIMT((β) =0.182).이원라집회귀화ROC곡선현시,평균cIMT위관상동맥병변적최강위험인자(OR=7.19、95％CI:2.00 ～ 25.93),기예측관상동맥중중도병변적개치교대(ROC=0.730、P=0.00、95％CI:0.68 ～0.78),단불능방조구분경도병변화정상관상동맥.차외,관상동맥반괴다분포재전강지(20.8％),성질이연반괴위주(42.5％).결론 60.2％적건강사체자피CCTA발현료관상동맥반괴.cIMT、년령、LDL-C화HDL-C가이교호지예측관상동맥중중도병변,단화경도병변관계불대.
Objective To assess the relationship between coronary plaques and risk factor of coronary heart disease in a asymptomatic population.Methods A total of 604 in-patients who received coronary computerized tomography angiography (CCTA) during January 1 th,2010 and April 1 th,2011 were enrolled in this study and assigned to the non-lesion group (0),mild lesion group (0 ＜ score ≤ 5) andmoderate-severe lesion group (＞ 5) according to the third quartile of CCTA score.Clinical data including physical examination,laboratory test,ultrasound sonogram and discharge diagnoses were collected and compared between the groups.Multivariable linear regression and bivariate logistic regression were performed to find out the main risk factors of coronary heart disease.ROC curve was drawn to estimate the diagnostic value of coronary lesions.Results There were 240 individuals in the non-lesion group,271 in the mild lesion group,93 in the moderate-severe lesion group.Multivariable linear regression indicated Y =-6.56 +3.22 × mean carotid intima-media thickness (cIMT) + 1.106 × male + 0.597 × low-density lipoprotein cholesterol (LDL-C) + 0.116 × age-1.596 × high-density lipoprotein cholesterol (HDL-C).Bivariate logistic regression and ROC curve showed that mean cIMT was the main risk factor of coronary heart disease (odds ratio (OR) =7.19,ROC =0.730,P=0.00,95％ confidence interval (CI):0.68 to 0.78).Furthermore,major coronary lesions were located in the LAD (20.8％) and was soft plaque (42.5％).Conclusion In this investigation,60.2％ of the asymptomatic patients showed plaques in CCTA.Age,cIMT,LDL-C and HDL-C may be predictive to moderate to severe coronary artery lesions.
