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颈动脉不同部位斑块与冠心病的关联研究
Correlation between plaques at different sites in the carotid arteries and risks of coronary heart disease
- 第三军医大学学报 2018年40卷第2期 页码：160-164
- 作者机构：
1.121001 辽宁 锦州，锦州医科大学
2.100034 北京，北京大学第一医院心内科
3.100191 北京，北京大学公共卫生学院
4.100039 北京，武警总医院医学工程科
- 作者简介：
[ 张岩，E-mail:drzhy1108@163.com ZHANG Yan, E-mail:drzhy1108@163.com
[ 仝青英，E-mail:benben6913@163.com TONG Qingying, E-mail:benben6913@163.com
- 基金信息：密歇根大学-北京大学医学部转化医学联合研究项目(BMU20110177)
DOI：10.16016/j.1000-5404.201708120
中图分类号： R181.32;R541.4;R543.4收稿：2017-08-19，
修回：2017-11-06，
纸质出版：2018-01-30
- 稿件说明：
移动端阅览
张本娜, 贾佳, 刘志科, 等. 颈动脉不同部位斑块与冠心病的关联研究[J]. 第三军医大学学报, 2018,40(2):160-164.
Benna ZHANG, Jia JIA, Zhike LIU, et al. Correlation between plaques at different sites in the carotid arteries and risks of coronary heart disease[J]. Journal of Third Military Medical University, 2018, 40(2): 160-164.
张本娜, 贾佳, 刘志科, 等. 颈动脉不同部位斑块与冠心病的关联研究[J]. 第三军医大学学报, 2018,40(2):160-164. DOI： 10.16016/j.1000-5404.201708120.
Benna ZHANG, Jia JIA, Zhike LIU, et al. Correlation between plaques at different sites in the carotid arteries and risks of coronary heart disease[J]. Journal of Third Military Medical University, 2018, 40(2): 160-164. DOI： 10.16016/j.1000-5404.201708120.
摘要
目的
2
探讨颈动脉不同部位斑块与冠心病的关系，为预防冠心病提供科学依据。
方法
2
采用横断面研究设计，对北京市石景山区古城社区和苹果园社区40岁及以上的社区居民进行一般人口学资料问卷调查、体格检查、生化指标检测以及颈动脉超声检查; 采用非条件Logistic回归分析不同部位的颈动脉斑块与冠心病的关系。
结果
2
共纳入3 840名研究对象，其中冠心病组481名(12.6%)，非冠心病组3 349(87.4%)。Logistic回归分析显示，调整年龄、性别、体质指数、文化程度、吸烟、饮酒、高血压、2型糖尿病、高血脂、血清总胆固醇、甘油三酯、高密度脂蛋白胆固醇、降压药物、降糖药物因素后，颈总动脉、颈动脉膨大部、颈内动脉，斑块检出者均比未检出者患冠心病风险高[(
OR
=1.486
95%
CI
：1.122~1.968)、(
OR
=1.501，95%
CI
：1.183~1.904)、(
OR
=1.566，95%
CI
：1.213~2.022)
]
; 颈总动脉、颈动脉膨大部、颈内动脉每增加一个斑块，冠心病风险分别增加26.5%(
OR
=1.265，95%
CI
：1.083~1.478)、24.7%(
OR
=1.247，95%
CI
：1.120~1.390)、30.5%(
OR
=1.305，95%
CI
：1.102~1.546)
颈内动脉斑块总面积每增加1mm
2
，冠心病患病风险增加1.6%
(
OR
=1.016，95%
CI
：1.005~1.027);斑块病变部位与冠心病的患病风险之间存在剂量-反应关系(线性趋势检验
P
<
0.001)。
结论
2
颈动脉不同部位的斑块与冠心病存在关联关系，且颈内动脉斑块与冠心病最具有关联性，颈动脉斑块病变部位数增加提示冠心病的患病风险增加。
Abstract
Objective
2
To explore the relationship between the presence of carotid plaques at different sites and the risks of coronary heart disease (CHD).
Methods
2
This cross-sectional study was conducted among residents from Gucheng and Pingguoyuan Communities of Shijingshan District
Beijing
China. The residents were asked to complete a questionnaire survey to collect the general data including gender
age
smoking
alcohol consumption
hypertension
hyperlipemia
type 2 diabetes mellitus
coronary heart disease
stroke and other medical conditions. Standardized
Methods
2
were used for physical examination
laboratory tests
and carotid artery ultrasonography. The relationship between carotid plaques at different sites and CHD was analyzed using non-conditional logistic regression.
Results
2
A total of 3 840 participants were enrolled in this study
including 481 (12.6%) with CHD and 3 349 (87.4%) without CHD. After adjustment for age
gender
body mass index (BMI)
education
smoking
drinking
hypertension
type 2 diabetes
hyperlipidemia
TG
TC
HDL-C
and the use of antihypertensive drugs and hypoglycemic agents
the patients with CHD were found to have significantly higher detection rates of plaques in the common carotid artery (
OR
=1.486
95%
CI
: 1.122~1.968)
carotid bulb (
OR
=1.501
95%
CI
: 1.183~1.904)
and internal carotid artery (
OR
=1.566
95%
CI
: 1.213-2.022) than the participants without CHD; the plaques at these 3 sites were associated with increased risks of CHD by 26.5% (
OR
=1.265
95%
CI
: 1.083~1.478)
24.7% (
OR
=1.247
95%
CI
: 1.120~1.390)
and 30.5% (
OR
=1.305
95%
CI
: 1.102~1.546)
respectively. An increase by 1 mm
2
of the total plaque area in the internal carotid artery was associated with an increase of the risk of CHD by 1.6% (
OR
=1.016
95%
CI
: 1.005~1.027);
a
dose-response relationship was found between the sites of plaques in the carotid arteries and the risk of CHD (
P
<
0.001 for the linear trend).
Conclusion
2
The plaques at different sites in the carotid arteries are associated with the risk of CHD. The presence of plaques in the internal carotid artery is most strongly associated with the risk of CHD
and an increase of the lesion site indicates an increased risk of CHD.
关键词
Keywords
references
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