CAJ | 학술논문

目的：探讨老年人下肢动脉粥样硬化与心血管危险因素的相关性。 　　方法：连续入选2013-05至2014-11于我科住院行下肢动脉彩色超声的患者700例，根据年龄分为青中年组（n=83例）、老年组（n=377例）、高龄老年组（n=240例），根据下肢动脉彩色超声对动脉硬化严重程度评分标准，其中正常患者112例、轻度硬化患者81例、中度硬化患者466例、重度硬化患者41例，比较其危险因素的差异。 　　结果：二分类多因素非条件Logistic回归分析示，年龄、吸烟、糖尿病史、血清尿酸（UA）、踝肱指数（ABI）是下肢动脉粥样硬化的独立危险因素[回归系数（B）分别为：0.144，1.496，0.963，0.004，-2.510；95%可信区间（CI）：1.120~1.190，2.257~8.824，1.456~4.716，1.001~1.007，0.012~0.534；P值：0.000，0.000，0.001，0.006，0.009]；有序多分类Logistic回归分析显示，年龄、男性、吸烟、ABI、UA、高血压病史与动脉硬化严重程度相关（回归系数分别为：0.130，0.737，0.592，-3.365，0.003，0.735；95%CI：0.097~0.162，0.222~1.252，0.052~1.132，-4.674~-2.055，0.001~0.005，0.313~1.157；P值：0.000，0.005，0.032，0.000，0.005，0.001）；与青中年组相比，老年组、高龄老年组中、重度硬化病变率明显较高；高龄老年组中、重度硬化病变率亦较老年组高（P均<0.01），差异有统计学意义；随着增龄，下肢动脉粥样硬化严重程度评分升高，差异有统计学意义（P＜0.01）。 　　结论：与青中年相比，老年人下肢动脉粥样硬化程度较重；增龄、吸烟、糖尿病史、UA、ABI是下肢动脉粥样硬化的独立危险因素；其严重程度与高龄、男性、吸烟、UA、ABI、高血压病史相关。
목적：탐토노년인하지동맥죽양경화여심혈관위험인소적상관성。 　　방법：련속입선2013-05지2014-11우아과주원행하지동맥채색초성적환자700례，근거년령분위청중년조（n=83례）、노년조（n=377례）、고령노년조（n=240례），근거하지동맥채색초성대동맥경화엄중정도평분표준，기중정상환자112례、경도경화환자81례、중도경화환자466례、중도경화환자41례，비교기위험인소적차이。 　　결과：이분류다인소비조건Logistic회귀분석시，년령、흡연、당뇨병사、혈청뇨산（UA）、과굉지수（ABI）시하지동맥죽양경화적독립위험인소[회귀계수（B）분별위：0.144，1.496，0.963，0.004，-2.510；95%가신구간（CI）：1.120~1.190，2.257~8.824，1.456~4.716，1.001~1.007，0.012~0.534；P치：0.000，0.000，0.001，0.006，0.009]；유서다분류Logistic회귀분석현시，년령、남성、흡연、ABI、UA、고혈압병사여동맥경화엄중정도상관（회귀계수분별위：0.130，0.737，0.592，-3.365，0.003，0.735；95%CI：0.097~0.162，0.222~1.252，0.052~1.132，-4.674~-2.055，0.001~0.005，0.313~1.157；P치：0.000，0.005，0.032，0.000，0.005，0.001）；여청중년조상비，노년조、고령노년조중、중도경화병변솔명현교고；고령노년조중、중도경화병변솔역교노년조고（P균<0.01），차이유통계학의의；수착증령，하지동맥죽양경화엄중정도평분승고，차이유통계학의의（P＜0.01）。 　　결론：여청중년상비，노년인하지동맥죽양경화정도교중；증령、흡연、당뇨병사、UA、ABI시하지동맥죽양경화적독립위험인소；기엄중정도여고령、남성、흡연、UA、ABI、고혈압병사상관。
Objective: To explore the relationship between lower extremity atherosclerosis disease (LEAD) and cardiovascular risk factors in elder people. Methods: A total of 700 consecutive patients receive lower extremity Color Doppler ultrasound in our hospital from 2013-05 to 2014-11 were investigated. The patients were divided into 3 age groups: Young and middle group, n=83, Elder group, n=377 and Senile group, n=240. Based on ultrasound scoring system, the patients were divided into 4 groups: Normal group, n=112, Mild atherosclerosis (Mild) group, n=81, Moderate group, n=466 and Severe group, n=41. The cardiovascular risk factors among different groups were compared. Results: Multivariate unconditional logistic regression analysis showed that age, smoking, history of diabetes, uric acid (UA), ankle-brachial index (ABI) were the independent risk factors for LEAD (B=0.144, 1.496, 0.963, 0.004, -2.510; 95% CI: 1.120-1.190, 2.257-8.824, 1.456-4.716, 1.001-1.007, 0.012-0.534;P=0.000, 0.000, 0.001, 0.006, 0.009 respectively. Ordinal logistic regression analysis indicated that age, male gender, smoking, ABI, UA, history of hypertension were related to the severity of atherosclerosis (B=0.130, 0.737, 0.592, -3.365, 0.003, 0.735; 95% CI: 0.097-0.162, 0.222-1.252, 0.052-1.132, -4.674 to -2.055, 0.001-0.005, 0.313-1.157;P=0.000, 0.005, 0.032, 0.000, 0.005, 0.001 respectively. Compared with Young and Middle groups, Elder and Senile groups had increased rates of moderate and severe arteriosclerotic lesions; compared with Elder group, Senile group presented the higher incidence of moderate and severe lesions, allP<0.01. With elevated age, the severity score of LEAD increased accordingly,P<0.01. Conclusion: Lower extremity atherosclerosis lesions were more severe in elder patient, and it was particularly severe in senile patients.