中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2014年
12期
941-946
,共6页
包柄楠%周迎生%刘军%霍勇
包柄楠%週迎生%劉軍%霍勇
포병남%주영생%류군%곽용
高血压%糖尿病%脑血管意外%10年发病风险
高血壓%糖尿病%腦血管意外%10年髮病風險
고혈압%당뇨병%뇌혈관의외%10년발병풍험
Hypertension%Diabetes mellitus%Cerebrovascular accident%10-year stroke risk
目的 评估高血压合并糖尿病患者卒中的10年发病风险,比较南、北方患者卒中的发病风险及相关危险因素.方法 2011年10月至2012年6月,采用多中心现况调查方法,在全国36家三级甲等医院心内科门诊完成15 914例患者调查.调查问卷是依据美国Framingham心脏研究中卒中10年发病风险评分量表而制定,以年龄、未治疗/治疗后的收缩压水平、吸烟、糖尿病病史、心血管疾病病史、心房颤动、左室肥厚作为调查指标,计算调查指标总分值,从卒中风险对照表中查出卒中发病概率.对发病风险分层,风险概率≤5％为低危,6％ ～9％为中危,≥10％为高危.结果 (1)15 914例患者的年龄(64.6±10.1)岁,收缩压为(138.7±19.3)mmHg(1 mmHg =0.133 kPa);心房颤动、左心室肥厚及心血管疾病的患病比例分别为7.4％,11.2％和57.2％;吸烟者比例为17.1％.与北方患者相比,南方高血压合并糖尿病患者具有高龄,男性比例、吸烟比例和左心室肥厚比例高(P值均＜0.01),而收缩压水平和心血管疾病比例低的特点(P值均＜0.05).(2)南方患者的10年平均发病风险高于北方患者[(22.4±17.1)％比(19.7±15.2)％,P＜0.01];在调整了年龄、性别后,差异仍有统计学意义(P＜0.05).(3)高血压合并糖尿病患者中,低危、中危和高危的患者比例分别为7.7％、17.4％和74.9％.其中,南方的低危、中危患者比例低于北方患者(6.7％比8.4％,15.5％比18.9％),而高危患者的比例高于北方患者(77.7％比72.7％),P值均＜0.01.结论 本研究中心内科门诊高血压合并糖尿病中老年患者卒中10年发病风险主要为高危风险分层患者,南方患者卒中10年平均发病风险高于北方患者.
目的 評估高血壓閤併糖尿病患者卒中的10年髮病風險,比較南、北方患者卒中的髮病風險及相關危險因素.方法 2011年10月至2012年6月,採用多中心現況調查方法,在全國36傢三級甲等醫院心內科門診完成15 914例患者調查.調查問捲是依據美國Framingham心髒研究中卒中10年髮病風險評分量錶而製定,以年齡、未治療/治療後的收縮壓水平、吸煙、糖尿病病史、心血管疾病病史、心房顫動、左室肥厚作為調查指標,計算調查指標總分值,從卒中風險對照錶中查齣卒中髮病概率.對髮病風險分層,風險概率≤5％為低危,6％ ～9％為中危,≥10％為高危.結果 (1)15 914例患者的年齡(64.6±10.1)歲,收縮壓為(138.7±19.3)mmHg(1 mmHg =0.133 kPa);心房顫動、左心室肥厚及心血管疾病的患病比例分彆為7.4％,11.2％和57.2％;吸煙者比例為17.1％.與北方患者相比,南方高血壓閤併糖尿病患者具有高齡,男性比例、吸煙比例和左心室肥厚比例高(P值均＜0.01),而收縮壓水平和心血管疾病比例低的特點(P值均＜0.05).(2)南方患者的10年平均髮病風險高于北方患者[(22.4±17.1)％比(19.7±15.2)％,P＜0.01];在調整瞭年齡、性彆後,差異仍有統計學意義(P＜0.05).(3)高血壓閤併糖尿病患者中,低危、中危和高危的患者比例分彆為7.7％、17.4％和74.9％.其中,南方的低危、中危患者比例低于北方患者(6.7％比8.4％,15.5％比18.9％),而高危患者的比例高于北方患者(77.7％比72.7％),P值均＜0.01.結論 本研究中心內科門診高血壓閤併糖尿病中老年患者卒中10年髮病風險主要為高危風險分層患者,南方患者卒中10年平均髮病風險高于北方患者.
목적 평고고혈압합병당뇨병환자졸중적10년발병풍험,비교남、북방환자졸중적발병풍험급상관위험인소.방법 2011년10월지2012년6월,채용다중심현황조사방법,재전국36가삼급갑등의원심내과문진완성15 914례환자조사.조사문권시의거미국Framingham심장연구중졸중10년발병풍험평분량표이제정,이년령、미치료/치료후적수축압수평、흡연、당뇨병병사、심혈관질병병사、심방전동、좌실비후작위조사지표,계산조사지표총분치,종졸중풍험대조표중사출졸중발병개솔.대발병풍험분층,풍험개솔≤5％위저위,6％ ～9％위중위,≥10％위고위.결과 (1)15 914례환자적년령(64.6±10.1)세,수축압위(138.7±19.3)mmHg(1 mmHg =0.133 kPa);심방전동、좌심실비후급심혈관질병적환병비례분별위7.4％,11.2％화57.2％;흡연자비례위17.1％.여북방환자상비,남방고혈압합병당뇨병환자구유고령,남성비례、흡연비례화좌심실비후비례고(P치균＜0.01),이수축압수평화심혈관질병비례저적특점(P치균＜0.05).(2)남방환자적10년평균발병풍험고우북방환자[(22.4±17.1)％비(19.7±15.2)％,P＜0.01];재조정료년령、성별후,차이잉유통계학의의(P＜0.05).(3)고혈압합병당뇨병환자중,저위、중위화고위적환자비례분별위7.7％、17.4％화74.9％.기중,남방적저위、중위환자비례저우북방환자(6.7％비8.4％,15.5％비18.9％),이고위환자적비례고우북방환자(77.7％비72.7％),P치균＜0.01.결론 본연구중심내과문진고혈압합병당뇨병중노년환자졸중10년발병풍험주요위고위풍험분층환자,남방환자졸중10년평균발병풍험고우북방환자.
Objective To assess the estimated 10-year risk of stroke among hypertensive outpatients known with diabetes from cardiovascular clinics of 36 tertiary hospitals in China and to analyze the characteristics of the risk factors and the 10-year risk of stroke between the southern and the northern patients.Methods A multi-center prevalence survey was conducted from October 2011 to June 2012.Hypertensive outpatients known with diabetes were enrolled from cardiovascular clinics of 36 tertiary hospitals in China.A total of 15 914 outpatients were included in the final analysis.The 10-year probability of stroke was evaluated by the Framingham stroke risk profile.According to the 10-year probability of stroke,patients were divided into low risk (≤ 5％),medium risk (6％ ～9％) and high risk (≥10％).Results (1) Of all the hypertensive outpatients known with diabetes,the mean age was (64.6 ± 10.1) years and the mean systolic pressure was (138.7 ± 19.3) mmHg(1 mmHg =0.133 kPa).Among them,7.4％ with atrial fibrillation,11.2％ with left ventricular hypertrophy,57.2％ with cardiovascular diseases,17.1％ smokers and 37.0％ using mono-hypoglycemic agent.The southern patients who were older with more smokers had higher proportions of men and left ventricular hypertrophy,lower Levels of systolic blood pressure,and lower proportions of other cardiovascular diseases than those of the northern patients (all P ＜ 0.05).(2) The mean 10-year probability of stroke was (20.9 ± 16.2) ％.The southern patients had a higher mean 10-year probability of stroke than that of the northern patients [(22.4 ± 17.1)％ vs (19.7 ± 15.2)％] (P ＜ 0.01).After adjusted by age and sex,the southern patients still had a higher mean 10-year probability of stroke (P ＜0.05).(3) All the patients had 7.7％ with low risk,17.4％ with medium risk,and 74.9％ with high risk.The southern patients had lower proportions of low and medium risk than those of the northern patients (6.7％ vs 8.4％,15.5％ vs 18.9％),but had a higher proportion of high risk than that of the northern patients (77.7％ vs 72.7％,all P ＜ 0.01).Conclusions Among the hypertensive outpatients known with diabetes from the cardiovascular clinics of our study,most of them were at the 10-year high risk of stroke.The southern patients had a higher mean 10-year probability of stroke than that of the northern patients.
