周皖舒， 彭年春， 时立新， 张　巧， 胡　颖， 徐淑静， 张　淼， 张　松， 李　红， 王　睿

(贵州医科大学附院 内分泌代谢病科， 贵州 贵阳　550004)



贵阳地区60岁以上老年人群心脑血管疾病危险因素研究*

周皖舒， 彭年春**， 时立新， 张巧， 胡颖， 徐淑静， 张淼， 张松， 李红， 王睿

(贵州医科大学附院 内分泌代谢病科， 贵州 贵阳550004)

目的： 探讨贵阳地区老年心脑血管疾病的危险因素。方法： 随机抽取贵阳地区1 865例老年人(≥60岁)作为研究对象，分为心脑血管疾病组及非心脑血管疾病组，并比较2组人群性别、年龄、体重指数(BMI)、腰臀比(WHR)、收缩压(SBP)、舒张压(DBP)、脉压(PP)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、血肌酐(Scr)、糖化血红蛋白(HbA1c)、踝臂指数(ABI)、吸烟、运动等指标；以心脑血管疾病为因变量，上述指标为自变量进行Logistic回归分析心脑血管疾病的独立影响因素。结果： 心脑血管疾病组ABI异常率高于非心脑血管疾病组，ABI均值低于非心脑血管疾病组(P<0.05)；心脑血管疾病组的年龄、SBP、PP、FPG、2hPG、SCr、HbA1c的水平及高血压、血脂异常症、糖尿病的比例均高于非心脑血管疾病组，运动的比例低于非心脑血管疾病组(P<0.05)，其余指标比较，差异无统计学意义(P>0.05)；Logistic回归分析结果显示，年龄(OR=1.135，P<0.01)、运动(OR=0.524，P<0.05)、高血压(OR=2.001，P<0.01)、血脂异常症(OR=2.201，P<0.01)和ABI异常(OR=3.560，P<0.01)是老年心脑血管疾病的独立影响因素。结论： ABI降低使贵阳地区的老年患者发生心脑血管疾病的风险增加，ABI、年龄、高血压、血脂异常症、运动是贵阳地区老年心脑血管疾病的独立影响因素。

心血管疾病； 脑血管损伤； 老年人； 踝臂指数； 高血压； 危险因素

[Abstract]Objective: To investigate the risk factors of cardio-cerebro vascular disease (CCVD) in elderly people of Guiyang city. Methods: 1 865 citizens aged 60 years or above living in Yunyan district of Guiyang city were randomly selected and were divided into CCVD group and non CCVD group. Gender, age, body mass index (BMI), waist to hip ratio (WHR), systolic blood pressure (SBP) and diastolic blood pressure (DBP), pulse pressure (PP), fasting plasma glucose (FPG), postprandial plasma glucose (2hPG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), serum creatinine (SCR), glycosylated hemoglobin (HbA1c), ankle brachial index (ABI)，smoking, sporting and other indicators of the 2 groups were compared. Taking CCVD as the dependent variable, the above indicators as the independent variables, the risk factors of CCVD were analyzed with Logistic regression analysis. Results: The proportion of patients with abnormal ABI in the CCVD group was higher than that of non CCVD group (P<0.05).The level of ABI of the CCVD group was lower than that of non CCVD group (P<0.05). The age, level of SBP, PP, 2hPG, SCr, HbA1c and the proportion of hypertension, dyslipidemia, diabetes for the CCVD group were higher than those of non CCVD group (P<0.05). The proportion of sporting was lower than that of non CCVD group (P<0.05). The differences of the other indicators between the 2 groups were not statistically significant. Logistic regression analysis indicated that age (OR=1.135,P<0.01), sporting (OR=0.524,P<0.05), hypertension (OR=2.001,P<0.01), dyslipidemia (OR=2.201,P<0.01), and abnormal ABI (OR=3.560,P<0.01) were all independent risk factors for geriatric CCVD. Conclusion: The risk of CCVD in elderly people of Guiyang city increases with decreased ABI. ABI, age, hypertension, dyslipidemia, sporting are the independent influencing factors of CCVD in the elderly of Guiyang city.

[Key words]cardiovascular disease； cerebrovascular trauma; elderly; ankle-brachia1 index; hypertension; risk factors

动脉粥样硬化是心脑血管疾病的病因基础，早期发现动脉硬化对预防心脑血管事件有积极的意义[1]。老年人是心脑血管疾病的高危人群，随着老龄化社会的到来，高危人群大量增加，心脑血管疾病将对人类的健康产生巨大的威胁[2-4]。踝臂指数(ankle-brachial index，ABI)是动脉粥样硬化检测指标，可作为心血管事件和功能障碍的预测指标[5-6]。研究显示，ABI降低与冠状动脉疾病和脑血管病患病率之间具有一定的相关性，推测通过ABI检测可筛选出将来更可能发生心脑血管事件的个体[7]。……