中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN PRACTICE OF CRITICAL CARE MEDICINE
2015年
1期
94-97
,共4页
急性冠脉事件%眼底微血管病变%危险因素
急性冠脈事件%眼底微血管病變%危險因素
급성관맥사건%안저미혈관병변%위험인소
Acute coronary event%Retinal microvascular disease%Risk factor
目的：探讨老年人眼底微血管病变与急性冠脉事件（ACE）的相关性。方法采用基于社区的病例对照方法，选择山东省济宁市兴隆庄煤矿社区1743例年龄≥60岁的居民进行问卷调查、体格检查和实验室检查。选取符合ACE诊断标准的139例患者作为观察组，1509例确定未患ACE作为对照组。采集两组性别、年龄、吸烟、饮酒、高血压、糖尿病、文化程度、体育锻炼、眼底微血管病变、空腹血糖、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、三酰甘油（TG）、收缩压、舒张压、体质量指数（BMI）进行单因素分析，将有统计学意义的危险因素进行多因素非条件logistic回归分析，筛选出影响ACE发生的独立危险因素。结果单因素分析显示，ACE发生的危险因素包括年龄、性别、吸烟、高血压、糖尿病、LDL-C、收缩压、舒张压、BMI、眼底微血管病变（P＜0.05或P＜0.01）。在眼底微血管病变中，观察组动静脉交叉征〔44.6%（62/139）比27.8%（419/1509）〕、硬性渗出〔9.4%（13/139）比4.9%（74/1509）〕、棉絮斑〔19.4%（27/139）比7.3%（110/1509）〕发生率明显高于对照组（P＜0.05或P＜0.01）。Logistic回归分析显示，年龄〔P＝0.002，优势比（OR）＝1.06，95%可信区间（95%CI）＝1.04～1.09〕、吸烟（P＝0.032，OR＝2.17，95%CI＝2.04～2.30）、眼底微血管病变（P＝0.010，OR＝2.33，95%CI＝0.97～1.27）、高血压（P＜0.001，OR＝5.21，95%CI＝4.11～6.36）、糖尿病（P＝0.021， OR＝1.03，95%CI＝1.01～1.05）及LDL-C（P＝0.020，OR＝2.80，95%CI＝2.65～2.99）是发生ACE的独立危险因素。结论眼底微血管病变是发生ACE的独立危险因素，眼底血管照相检查可以作为预测ACE的检查方法。
目的：探討老年人眼底微血管病變與急性冠脈事件（ACE）的相關性。方法採用基于社區的病例對照方法，選擇山東省濟寧市興隆莊煤礦社區1743例年齡≥60歲的居民進行問捲調查、體格檢查和實驗室檢查。選取符閤ACE診斷標準的139例患者作為觀察組，1509例確定未患ACE作為對照組。採集兩組性彆、年齡、吸煙、飲酒、高血壓、糖尿病、文化程度、體育鍛煉、眼底微血管病變、空腹血糖、高密度脂蛋白膽固醇（HDL-C）、低密度脂蛋白膽固醇（LDL-C）、三酰甘油（TG）、收縮壓、舒張壓、體質量指數（BMI）進行單因素分析，將有統計學意義的危險因素進行多因素非條件logistic迴歸分析，篩選齣影響ACE髮生的獨立危險因素。結果單因素分析顯示，ACE髮生的危險因素包括年齡、性彆、吸煙、高血壓、糖尿病、LDL-C、收縮壓、舒張壓、BMI、眼底微血管病變（P＜0.05或P＜0.01）。在眼底微血管病變中，觀察組動靜脈交扠徵〔44.6%（62/139）比27.8%（419/1509）〕、硬性滲齣〔9.4%（13/139）比4.9%（74/1509）〕、棉絮斑〔19.4%（27/139）比7.3%（110/1509）〕髮生率明顯高于對照組（P＜0.05或P＜0.01）。Logistic迴歸分析顯示，年齡〔P＝0.002，優勢比（OR）＝1.06，95%可信區間（95%CI）＝1.04～1.09〕、吸煙（P＝0.032，OR＝2.17，95%CI＝2.04～2.30）、眼底微血管病變（P＝0.010，OR＝2.33，95%CI＝0.97～1.27）、高血壓（P＜0.001，OR＝5.21，95%CI＝4.11～6.36）、糖尿病（P＝0.021， OR＝1.03，95%CI＝1.01～1.05）及LDL-C（P＝0.020，OR＝2.80，95%CI＝2.65～2.99）是髮生ACE的獨立危險因素。結論眼底微血管病變是髮生ACE的獨立危險因素，眼底血管照相檢查可以作為預測ACE的檢查方法。
목적：탐토노년인안저미혈관병변여급성관맥사건（ACE）적상관성。방법채용기우사구적병례대조방법，선택산동성제저시흥륭장매광사구1743례년령≥60세적거민진행문권조사、체격검사화실험실검사。선취부합ACE진단표준적139례환자작위관찰조，1509례학정미환ACE작위대조조。채집량조성별、년령、흡연、음주、고혈압、당뇨병、문화정도、체육단련、안저미혈관병변、공복혈당、고밀도지단백담고순（HDL-C）、저밀도지단백담고순（LDL-C）、삼선감유（TG）、수축압、서장압、체질량지수（BMI）진행단인소분석，장유통계학의의적위험인소진행다인소비조건logistic회귀분석，사선출영향ACE발생적독립위험인소。결과단인소분석현시，ACE발생적위험인소포괄년령、성별、흡연、고혈압、당뇨병、LDL-C、수축압、서장압、BMI、안저미혈관병변（P＜0.05혹P＜0.01）。재안저미혈관병변중，관찰조동정맥교차정〔44.6%（62/139）비27.8%（419/1509）〕、경성삼출〔9.4%（13/139）비4.9%（74/1509）〕、면서반〔19.4%（27/139）비7.3%（110/1509）〕발생솔명현고우대조조（P＜0.05혹P＜0.01）。Logistic회귀분석현시，년령〔P＝0.002，우세비（OR）＝1.06，95%가신구간（95%CI）＝1.04～1.09〕、흡연（P＝0.032，OR＝2.17，95%CI＝2.04～2.30）、안저미혈관병변（P＝0.010，OR＝2.33，95%CI＝0.97～1.27）、고혈압（P＜0.001，OR＝5.21，95%CI＝4.11～6.36）、당뇨병（P＝0.021， OR＝1.03，95%CI＝1.01～1.05）급LDL-C（P＝0.020，OR＝2.80，95%CI＝2.65～2.99）시발생ACE적독립위험인소。결론안저미혈관병변시발생ACE적독립위험인소，안저혈관조상검사가이작위예측ACE적검사방법。
Objective To study the relationships between retinal microvascular disease and acute coronary event (ACE) among aged people. Methods A controlled study for senile people in communities was conducted. Xinglong Zhuang Coal Mine Community in Jining city, Shandong province was chosen to carry out the study, and the residents in that area aged≥60 years were asked to take questionnaire survey, physical and laboratory examinations. There were 139 cases met the diagnostic criteria of ACE being in the observation group, and 1 509 cases without ACE were assigned in the control group. The gender, age, smoking, alcohol intake, hypertension, diabetes mellitus, education, physical exercise, retinal microvascular disease, fasting blood-glucose, high density lipoprotein cholesterin (HDL-C), low density lipoprotein cholesterin (LDL-C), triacylglycerol (TG), systolic pressure, diastolic pressure, body mass index (BMI) were collected in the two groups to perform univariate analysis. Multivariate non-conditional logistic regression analysis was used for the factors with statistical significance to screen out the independent risk factors that could affect the occurrence of ACE. Results The univariate analysis showed:the risk factors that might cause the occurrence of ACE included age, gender, smoking, hypertension, diabetes mellitus, LDL-C, systolic pressure, diastolic pressure, BMI, and retinal microvascular disease (P<0.05 or P<0.01). In the ACE patients of observation group, the rates of presence of arteriovenous crossing sign [44.6%(62/139) vs. 27.8%(419/1 509)], hard exudates [9.4%(13/139) vs. 4.9%(74/1 509)] and cotton-wool patches [19.4%(27/139) vs. 7.3%(110/1 509)] in retinal microvascular disease were significantly higher than those in control group (P<0.05 or P<0.01). The logistic regression analysis showed:age [P=0.002, odds ratio (OR)=1.06, 95%confidence interval (95%CI)=1.04-1.09], smoking (P=0.032, OR=2.17, 95%CI=2.04-2.30), retinal microvascular disease (P = 0.010, OR = 2.33, 95%CI = 0.97 - 1.27), hypertension (P < 0.001, OR = 5.21, 95%CI=4.11-6.36), diabetes mellitus (P=0.021, OR=1.03, 95%CI=1.01-1.05) and LDL-C (P=0.020, OR=2.80, 95%CI = 2.65 - 2.99) were the independent risk factors for the occurrence of ACE. Conclusions Retinal microvascular disease is the independent risk factor for the occurrence of ACE. The retinal angiography can be a useful examination to forecast ACE.
