Frank征与心血管疾病的相关性研究

发布时间：2018-12-06 11:36

【摘要】：背景与目的:Frank征又名耳垂折痕征,是人群中常见的体表标志。既往国外流行病学研究发现Frank征阳性者发生动脉粥样硬化性心血管疾病的风险明显增高,提示Frank征可能成为早期发现心血管疾病的一个线索。但这一特点是否有种族差异尚不清楚,尤其是在中国汉族人群中Frank征与心血管疾病是否相关尚缺乏资料。本研究旨在通过收集分析陕西省人民医院心内科住院患者的临床资料及Frank征特点,探讨中国汉族人群中Frank征与心血管疾病(冠心病、高血压病、糖尿病)之间的相关性,以期为心血管疾病的早期诊断提供简单的临床线索。方法:纳入2016年1月到2016年12月期间陕西省人民医院心内科连续住院的2000例病人(男性1097人,平均年龄64岁),详细记录其病史及各项生化检查资料,并由专人判断Frank征特点并拍照留存,分为Frank征阳性组、Frank征阴性组,其中阳性标准为双侧或单侧耳垂折痕长度大于整个耳垂的1/3。分别采用卡方检验比较Frank征阳性组与Frank征阴性组的分类变量(高血压病、糖尿病、冠心病、吸烟史、饮酒史、肾脏病史、性别)之间的差异;T检验来分析Frank征阳性组与Frank征阴性组的数值变量(低密度脂蛋白、高密度脂蛋白、甘油三酯及尿酸)的差异;二分类Logistic回归分析探究Frank征与心血管病的相关性。结果:1.Frank征阳性组有1092例,其发生率为54.6%。2.Frank征阳性组男性发生率明显高于Frank征阴性组男性发生率(59.9%vs 48.8%),差异有统计学意义(P0.001);Frank征阳性组平均年龄(68.62±10.49)明显高于Frank征阴性组平均年龄(59.29±11.92),差异有统计学意义(P0.001);Frank征阳性组冠心病发生率明显高于Frank征阴性组冠心病发生率(61.4%vs 51.3%),差异有统计学意义(P0.001);Frank征阳性组高血压病发生率明显高于Frank征阴性组高血压病发生率(62.3%vs 54.1%),差异有统计学意义(P0.001);Frank征阳性组糖尿病发生率明显高于Frank征阴性组糖尿病发生率(28.6%vs 21.1%),差异有统计学意义(P0.001)。3.Frank征阳性组肾脏病发生率与Frank征阴性组肾脏病发生率之间无统计学差异(5.6%vs 5.0%)(P=0.531);Frank征阳性组吸烟者与Frank征阴性组吸烟者之间无统计学差异(27.5%vs 24.6%)(P=0.140);Frank征阳性组饮酒者与Frank征阴性组饮酒者之间无统计学差异(4.6%vs 4.8%)(P=0.779)。4.Frank征阳性组甘油三酯平均值(1.48±0.94)明显低于Frank征阴性组甘油三酯平均值(1.60±1.00),差异有统计学意义(P=0.031);Frank征阳性组低密度脂蛋白平均值(2.50±0.82)与Frank征阴性组低密度脂蛋白平均值(2.32±0.96)之间无统计学差异(P=0.183);Frank征阳性组高密度脂蛋白平均值(1.53±13.21)与Frank征阴性组高密度脂蛋白平均值(1.14±0.34)之间无统计学差异(P=0.163);Frank征阳性组尿酸平均值(329.31±116.34)明显高于Frank征阴性组尿酸平均值(320.13±100.92),差异有统计学意义(P=0.006)。5.非条件二分类回归分析得到Frank征与年龄、性别、糖尿病、高血压病、冠心病有显著相关性(P=0.000,P=0.000,P=0.035,P=0.024,P=0.008),且Frank征阳性患者冠心病发生率比Frank征阴性患者高1.9倍。结论:1.心血管及其相关疾病患者中,Frank征的阳性率较高,可达54.6%,且有性别差异。2.Frank征可作为心血管疾病及其相关疾病的早期识别线索,对于年轻男性患者Frank征预测心血管疾病的价值更大。
[Abstract]:BACKGROUND & OBJECTIVE: Frank's sign, also known as the earlobe crease sign, is a common body surface marker in the population. Prior foreign epidemiological studies have found that there is a marked increase in the risk of atherosclerotic cardiovascular disease in the case of Frank's positive people, suggesting that Frank's sign may be a clue to the early detection of cardiovascular disease. However, it is not clear whether there is a racial difference in this feature, especially whether Frank's sign and cardiovascular disease are still lacking in the Chinese Han population. The purpose of this study is to study the correlation between Frank's sign and cardiovascular disease (coronary heart disease, hypertension, and diabetes) in Chinese Han population by collecting the clinical data and the characteristics of Frank's sign in the patients in the heart of the People's Hospital of Shaanxi Province. in order to provide a simple clinical clue for the early diagnosis of the cardiovascular disease. Methods: In the period from January 2016 to December 2016, 2000 patients (1097 men and 64 years of age) of the Department of Cardiology of the People's Hospital of Shaanxi Province were included, and the medical history and the biochemical examination data were recorded in detail. The Frank sign-negative group, where the positive standard is the double side or one-sided earlobe fold length is greater than 1/ 3 of the total ear lobe. The difference between Frank's positive group and Frank's negative group (hypertension, diabetes, coronary heart disease, smoking history, history of drinking, history of kidney disease, sex) was compared by the card-side test, respectively. T-test was used to analyze the difference between Frank's positive group and Frank's negative group (low density lipoprotein, high-density lipoprotein, triglyceride and uric acid). Results: 1. The incidence of positive group of positive group was 54. 6%. The incidence of male in positive group was higher than that of the negative group of Frank (55.9% vs. 48. 8%), and the difference was statistically significant (P 0.001). The mean age of Frank's positive group was significantly higher than that of Frank's negative group (59. 29, 11.92). The difference was significant (P 0.001). The incidence of coronary heart disease in the positive group of Frank was significantly higher than that of the negative group of Frank (61.4% vs. 51.3%), and the difference was significant (P 0.001). The incidence of hypertension in the positive group of Frank's positive group was significantly higher than that of the negative group of Frank (62.3% vs. 54.1%), and the difference was significant (P 0.001), and the incidence of diabetes in the positive group of Frank's positive group was higher than that of the negative group of Frank (28. 6% vs. 21.1%). There was no statistical difference (P = 0.531) between the incidence of renal disease and the incidence of renal disease in the negative group of the Frank sign (P = 0. 531), and there was no statistical difference between the positive group of the positive group and the negative group of the Frank sign (P = 0.140). There was no statistical difference (4.6% vs. 4.8%) between the positive group and the negative group of Frank (P = 0.779). The mean value of triglyceride (1.48% 0.94) in the positive group was significantly lower than that of the negative group in the negative group (1.60% and 1.00), and the difference was statistically significant (P = 0.031). There was no statistical difference (P = 0.183) between the mean of low-density lipoprotein (2.50-0.82) and the average of low-density lipoprotein (2.32-0.96) in the negative group of Frank-positive group. The mean value of high-density lipoprotein (1.53-13.21) in the positive group and the mean value of high-density lipoprotein (1.14-0.34) in the negative group of the Frank-positive group were not statistically different (P = 0.163), and the average of uric acid (32.9. 31-116. 34) in the positive group of the Frank-positive group was significantly higher than the average of uric acid in the negative group of Frank (33.2. 13-100. 92). The difference was significant (P = 0. 006). There was a significant correlation between Frank's sign and age, sex, diabetes, hypertension and coronary heart disease (P = 0.000, P = 0.000, P = 0. 035, P = 0. 024, P = 0. 008). Conclusion: 1. In the patients with cardiovascular and related diseases, the positive rate of Frank's sign is high, it can reach 54. 6%, and there is a gender difference. 2. Frank's sign can be used as an early identification clue for cardiovascular diseases and related diseases.
【学位授予单位】：西安医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R54;R764

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