中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2014年
7期
801-805
,共5页
童璐莎%姜雯红%严慎强%楼敏%张建民
童璐莎%薑雯紅%嚴慎彊%樓敏%張建民
동로사%강문홍%엄신강%루민%장건민
颈动脉斑块/内膜增厚%颈部血管彩超%卒中一级预防%预测模型
頸動脈斑塊/內膜增厚%頸部血管綵超%卒中一級預防%預測模型
경동맥반괴/내막증후%경부혈관채초%졸중일급예방%예측모형
Carotid plaque/thickened intima%Cervical vascular ultrasound%Primary stroke prevention%Predictive model
目的 建立简便有效的颈动脉斑块/内膜增厚的预测模型,为临床工作中拟定筛查指标提供依据.方法 回顾性分析收集杭州市2个社区2012年9月至2013年3月的卒中筛查数据共14 226例,年龄≥40岁的常住居民自愿参加筛查项目且完成血压、空腹血脂、空腹血糖及颈部血管B超检查,随机抽样1000例进行分析,以颈动脉斑块/内膜增厚为结局,以是否出现颈动脉内膜斑块/内膜增厚分为2组,对相关临床指标进行临床资料分析和Logistic回归,建立评分模型并以C值检验预测效能.结果 随机抽取的1000例样本中,164例有颈动脉斑块/内膜增厚.独立危险因素为高龄、男性、吸烟、糖尿病、高血压、高LDL-C血症(高低密度脂蛋白胆固醇血症),最佳预测模型的C值=0.804,高危诊断点3.5,敏感度0.713,特异度0.757.结论 本研究建立了更简便有效的颈动脉斑块/内膜增厚的预测模型,可进一步应用于颈动脉筛查和卒中一级预防.
目的 建立簡便有效的頸動脈斑塊/內膜增厚的預測模型,為臨床工作中擬定篩查指標提供依據.方法 迴顧性分析收集杭州市2箇社區2012年9月至2013年3月的卒中篩查數據共14 226例,年齡≥40歲的常住居民自願參加篩查項目且完成血壓、空腹血脂、空腹血糖及頸部血管B超檢查,隨機抽樣1000例進行分析,以頸動脈斑塊/內膜增厚為結跼,以是否齣現頸動脈內膜斑塊/內膜增厚分為2組,對相關臨床指標進行臨床資料分析和Logistic迴歸,建立評分模型併以C值檢驗預測效能.結果 隨機抽取的1000例樣本中,164例有頸動脈斑塊/內膜增厚.獨立危險因素為高齡、男性、吸煙、糖尿病、高血壓、高LDL-C血癥(高低密度脂蛋白膽固醇血癥),最佳預測模型的C值=0.804,高危診斷點3.5,敏感度0.713,特異度0.757.結論 本研究建立瞭更簡便有效的頸動脈斑塊/內膜增厚的預測模型,可進一步應用于頸動脈篩查和卒中一級預防.
목적 건립간편유효적경동맥반괴/내막증후적예측모형,위림상공작중의정사사지표제공의거.방법 회고성분석수집항주시2개사구2012년9월지2013년3월적졸중사사수거공14 226례,년령≥40세적상주거민자원삼가사사항목차완성혈압、공복혈지、공복혈당급경부혈관B초검사,수궤추양1000례진행분석,이경동맥반괴/내막증후위결국,이시부출현경동맥내막반괴/내막증후분위2조,대상관림상지표진행림상자료분석화Logistic회귀,건립평분모형병이C치검험예측효능.결과 수궤추취적1000례양본중,164례유경동맥반괴/내막증후.독립위험인소위고령、남성、흡연、당뇨병、고혈압、고LDL-C혈증(고저밀도지단백담고순혈증),최가예측모형적C치=0.804,고위진단점3.5,민감도0.713,특이도0.757.결론 본연구건립료경간편유효적경동맥반괴/내막증후적예측모형,가진일보응용우경동맥사사화졸중일급예방.
Objective To establish a practical and effective predictive model for predicting carotid plaque/thickened intima,and to provide a novel perspective for stroke screening.Methods A retrospective analysis of the community screening data collected from September 2012 to March 2013 was performed.The data of blood pressure,serum lipid profile and fasting blood glucose and ultrasonographic checks of carotid artery were documented.One thousand subjects were randomly sampled from totally 14 226 individuals and divided into 2 groups according to the presence of carotid plaque/thickened intima.Analysis of relevant data of subjects with Logistic regression were performed.Predictive model was established according to the odds ratio for each risk factor and evaluated by C statistics.Results In the randomly sampled 1000 subjects,164 ones were found to be with carotid plaque/thickened intima.The mean age was (60.23 ± 10.09) years old,110 (67.1％) were male.Smoker,hypertension,angina pectoris,diabetes and hyperlipidemia were seen more often in the subjects with carotid plaque/thickened intima.Logistic regression analysis showed the independent risk factors for carotid plaque/thickened intima included advanced age (OR =1.15,95％ CI:1.12-1.84,P＜0.01),male (OR=3.97,95％CI:2.49-6.33,P＜0.01),smoking (OR=1.80,95％CI:1.24-2.56,P =0.002),diabetes (OR =1.80,95％ CI:1.15-2.98,P =0.012),hypertension (OR =2.82,95％ CI:1.15-2.98,P ＜ 0.01),high total cholesterol level (OR =1.63,95％ CI:1.31-2.02,P ＜ 0.01) and high LDL-C (low density lipoprotein-cholesterol) level (OR =1.70,95 ％ CI:1.35-2.14,P ＜ 0.01).The advanced age was found to be the strongest predictive factor in this model.The C statistics of this model is 0.804,which overweighs other models previously reported.The optimal cutoff point for prediction was 3.5,with a sensitivity of 0.713 and a specificity of 0.757.Conclusion An practical and effective model for predicting carotid plaque/thickened intima established from sampling data of community residents is favorable for both stroke screening and primary stroke prevention.
