中老年自然人群颈动脉粥样硬化现况调查暨传统心血管病危险因素与颈动脉粥样硬化的关系

【作者】 吕敏；

【导师】 武阳丰； 李莹；

【作者基本信息】 中国协和医科大学 ， 流行病学与卫生统计， 2004， 博士

【摘要】 中老年自然人群颈动脉粥样硬化现况调查 目的： 了解我国中老年自然人群颈动脉颈动脉粥样硬化现况，研究我国中老年自然人群颈动脉粥样硬化与心血管病的关系，研究我国中老年自然人群颈动脉粥样硬化的相关因素，探讨预防颈动脉粥样硬化发生的措施。 方法： 2002年9月对北京石景山区43～73岁农村居民1202人进行心血管病随访和危险因素横断面调查及颈动脉超声检查。应答率为85.7％。受检率为86.2％。抽取20名研究对象重复进行颈动脉超声检查，以评价医师之间和医师本身的重复性。两名医师测量IMT和血管内径的结果无显著差异，IMT相关系数为0.69，血管内径相关系数为0.83～0.90；斑块检出的一致率达到97.5％(κ=0.950)，斑块面积亦无显著差异，两医师相关系数为0.955；P＜0.01。医师对同一研究对象前后两次测量IMT和血管内径的结果无显著差异，IMT相关系数为0.69，血管内径相关系数为0.69～0.81；斑块检出的一致率达到85％(κ=0.696)，斑块面积亦无显著差异，医师相关系数为0.833；P＜0.01。采用SPSS10.0统计软件包进行数据分析。将P＜0.05设为统计学显著水平。 结果： 1．颈动脉粥样硬化指标的分布特征： (1) IMT：全部人群IMT在0.48～1.23mm之间，均值为0.71±0.10mm，男性为0.73±0.10mm(0.48～1.11mm)，女性为0.70±0.09mm(0.48～1.23mm)，男性厚于女性(P＜0.01)；无论男女，IMT均随年龄增大呈现增厚趋势，P＜0.01；颈动脉窦部IMT均值最厚，远端次之(p＜0.01)。 (2) 斑块：全部人群斑块阳性率为36.9％(444／1202)，男性(47.2％)明显高于女性(31.3％)。随年龄增加，男女斑块阳性率均呈上升趋势，P＜0.01。硬斑检出率为24.0％(288／1202)，软斑检出率为24.5％(295／1202)，混合斑检出率为31.9％(384／1202)。斑块平均数目和平均面积均随年龄增加而呈现增大趋势，更多还原

【Abstract】 ObjectiveThe aim of this study was to describe the distribution of carotid atherosclerosis in the middle-aged and senile population in China; to evaluate the relationship of carotid atherosclerosis to cardiovascular disease; and to explore its relative factors.MethodsA cross-sectional study on cardiovascular disease and relative risk factors was carried out in 1394 subjects, aged 43-73, in suburban in Beijing in Sep, 2002. The response rate was 85.7%. Carotid lesions were detected and evaluated high-resolution B-mode ultrasonography in 1202 subjects, with the participation rate 86.2%.The inter- and intra-reproducibility of the measurements were assessed for the intima-media thickness (IMT), vessel interior diameter and plaque in 20 subjects. There was no statistically significant difference between two technicians for IMT, interior diameter and plaque areas, with r=0.69, r=0.83-0.90 and r=0.95, respectively. As for plaque, the coincidence rate was 97.5% between the two technicians (κ =0.950).The intra-reproducibility was evaluated between the first and the second measurements by each technician. The correlation was 0.69 for IMT, 0.69-0.81 for interior diameter and 0.83 for plaque area. 85% of the first plaque coincided with the second one (κ=0.696).SPSS 10.0 software package was used for the analysis. Plaque number and plaque area were converted into natural logarithms to make their distribution canonical before further analysis. A value of p<0.05 was considered statistically significant.更多还原