青中年未绝经女性动脉粥样硬化相关危险因素探讨
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(1.山东省卫生健康宣传教育中心,山东省济南市 2511;2.山东第一医科大学 山东省医学科学院校医院, 山东省泰安市 2710;3.山东第一医科大学第二附属医院心内科,山东省泰安市 2710)

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何晓,硕士研究生,住院医师,研究方向为心血管疾病预防与健康管理,E-mail为934095653@qq.com。通信作者李秀昌,医学博士,教授,研究方向为心血管疾病的基础与临床,E-mail为tsmcli@163.com。

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Risk factors of atherosclerosis in young and middle-aged premenopausal women
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1.Shandong Provincial Health Publicity and Education Center, Jinan, Shandong 2511, China;2.School Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong 2710, China;3.Department of Cardiology, the Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong 2710, China)

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    目的 通过检测青中年未绝经女性各项生物化学指标及其他暴露因素,探讨青中年未绝经女性发生动脉粥样硬化(As)的相关危险因素。方法 本研究样本来自2013年1月至2016年3月泰山医学院附属医院就诊或者健康体检的青中年女性(≤50岁),共筛选出符合条件的青中年未绝经女性390位,年龄26~50岁,平均(45.6±4.4)岁。所有研究对象均采用高频线阵超声探测颈总动脉、颈内外动脉分叉处及颈内动脉颅外段的横轴和纵轴实时二维图像,测量动脉管壁内膜中膜厚度及有无斑块。入选者分为2组:As组191例,对照组199例。详细询问所有入选对象的既往病史及家族遗传史并测量血压、身高、体质量等;自动生物化学分析仪测定血脂、空腹血糖、糖化血红蛋白、无机离子、肝功能、肾功能、甲状腺功能、血细胞分析、尿液分析等指标。结果 As组与对照组间年龄、3级高血压、糖尿病病史、长期饮酒史、吸烟史(含被动吸烟)、早发冠心病家族史、低密度脂蛋白胆固醇、总胆固醇、载脂蛋白B、β2微球蛋白、空腹血糖、糖化血红蛋白、尿葡萄糖、碳酸氢根、氯离子等具有显著性差异(P<0.05)。单因素Logistic回归分析结果显示,青中年未绝经女性As的发生与年龄、3级高血压、糖尿病病史、长期饮酒史、吸烟史(含被动吸烟)、早发冠心病家族史、低密度脂蛋白胆固醇、总胆固醇、载脂蛋白B、β2微球蛋白、空腹血糖、糖化血红蛋白、尿葡萄糖、血碳酸氢根等呈正相关。进一步行多因素Logistic回归分析表明,年龄、3级高血压、长期饮酒史、吸烟史(含被动吸烟)、早发冠心病家族史、低密度脂蛋白胆固醇升高等为青中年女性As发生的独立危险因素。结论 年龄、3级高血压、长期饮酒史、吸烟史(含被动吸烟)、早发冠心病家族史、低密度脂蛋白胆固醇升高等是青中年未绝经女性As发生的独立危险因素。

    Abstract:

    Aim To explore the risk factors of atherosclerosis (As) in young and middle-aged premenopausal women by detecting the biochemical indicators and other exposure factors of young and middle-aged premenopausal women.Methods Young women (≤50 years old) who underwent physical examination in the Affiliated Hospital of Taishan Medical University from January 2013 to March 2016 were involved into this study. 390 young premenopausal women were enrolled, aged 26-50 years old, with an average of (45.6±4.4) years old. Carotid arteries of all the cases were assessed using PHILIPS iE 33 color Doppler echocardiography system with the liner probe of 7.5-10 MHz frequency. The arterial intima-media thickness and plaque were measured and recorded. According to the echo results, the cases were divided into 2 groups:As group (n=191) and Control group (n=199). Detailed inquiries were made on the past medical history and family genetic history of all the selected subjects, and blood pressure, height and body mass were measured. The indexes of blood lipid, fasting blood sugar, glycosylated hemoglobin, inorganic ions, liver function, kidney function, thyroid function, blood cell analysis and urine analysis were determined by automatic biochemical analyzer. Results The differences of age, grade 3 hypertension, diabetes history, long-term drinking history, smoking history (including passive smoking), family history of early onset coronary heart disease, low density lipoprotein cholesterol, total cholesterol, apolipoprotein B, β2 microglobulin, fasting blood sugar, glycosylated hemoglobin, urinary glucose, bicarbonate, chloride ion were statistically significant between the As group and the control group (P<0.05). Univariate Logistic regression analysis showed that the incidence of As in young, middle-aged and premenopausal women was positively correlated with age, grade 3 hypertension, diabetes history, long-term drinking history, smoking history (including passive smoking), family history of early coronary heart disease, low density lipoprotein cholesterol, total cholesterol, apolipoprotein B, β2 microglobulin, fasting blood glucose, glycosylated hemoglobin, urinary glucose, blood bicarbonate, etc. Further multivariate Logistic regression analysis showed that age, grade 3 hypertension, long-term drinking history, smoking history (including passive smoking), family history of early onset coronary heart disease and elevated low density lipoprotein cholesterol were independent risk factors for As in young and middle-aged women. Conclusion Age, grade 3 hypertension, long-term drinking history, smoking history (including passive smoking), family history of early onset coronary heart disease and elevated low density lipoprotein cholesterol are independent risk factors for As in young and middle-aged premenopausal women.

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何晓,李素梅,刘立波,刘晓红,李秀昌.青中年未绝经女性动脉粥样硬化相关危险因素探讨[J].中国动脉硬化杂志,2020,28(1):49~53, 64.

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  • 收稿日期:2019-04-24
  • 最后修改日期:2019-05-30
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  • 在线发布日期: 2019-12-18