老年人下肢动脉粥样硬化与心血管危险因素相关性分析

发布时间：2018-05-08 11:54

本文选题：老年人 + 下肢动脉粥样硬化　；参考：《重庆医科大学》2015年硕士论文

【摘要】：目的：探讨老年人下肢动脉粥样硬化的特点及与心血管危险因素的相关性,并比较不同程度动脉粥样硬化危险因素的分布特点,探讨其高危因素,为其临床防治提供依据。方法：连续选取重庆医科大学附属第二医院老年病科2013年5月至2014年11月行下肢动脉彩超检查的住院患者共计700例。根据年龄分为青中年组(42～59岁)83例,男39例,女44例,平均54.99±4.18岁；老年组(60～79岁)377例,男161例,女216例,平均70.01±5.87岁；高龄老年组(80～100岁)240例,男119例,女121例,平均84.06±3.51岁。根据下肢动脉彩超结果进行严重程度评分,将动脉硬化严重程度分为正常组112例(男29例,女83例),平均62.51±7.96岁,轻度硬化组81例(男23例,女58例),平均68.14±8.17岁,中度硬化组466例(男238例,女228例),平均75.65±9.49岁,重度硬化组41例(男29例,女12例),平均81.88±7.12岁。采集入选患者的年龄、性别、身高、体重、吸烟史、高血压病史、糖尿病史,体质指数(BMI)=体重/身高2(kg/m2),记录全天平均收缩压(SBP)与舒张压(DBP)、血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、空腹血糖(FBG)、早餐后2h血糖(2hPBG)、糖化血红蛋白(HbAlc)、血浆纤维蛋白原(Fib)、肌酐(Cr)、尿酸(UA)、超敏C反应蛋白(hs-CRP)、踝肱指数(ABI)。比较各年龄层次、不同严重程度LEAD危险因素的特点,并分析其相关性。结果：二分类多因素非条件的Logistic回归分析显示,高龄、吸烟、糖尿病史、血清尿酸(UA)、踝肱指数(ABI)是下肢动脉粥样硬化的独立危险因素(p均0.05)；有序多分类Logistic回归分析显示,高龄、男性、吸烟、UA、ABI、高血压病史与动脉硬化严重程度相关(p均0.05)；与青中年组相比,老年组、高龄老年组中、重度硬化病变率明显较高；高龄老年组中、重度硬化病变率亦较老年组高(p均0.01)；随着增龄,下肢动脉粥样硬化严重程度评分升高(p0.01)。结论：与青中年相比,老年人下肢动脉粥样硬化程度较重；增龄、吸烟、糖尿病史、UA、ABI是下肢动脉粥样硬化的独立危险因素；本研究中,下肢动脉粥样硬化严重程度与高龄、男性、吸烟、UA、ABI、高血压病史相关。
[Abstract]:Objective: to investigate the characteristics of lower extremity atherosclerosis and its correlation with cardiovascular risk factors in the elderly, and to compare the distribution characteristics of risk factors of atherosclerosis of different degrees, and to explore the high risk factors of atherosclerosis in order to provide the basis for clinical prevention and treatment. Methods: a total of 700 inpatients were selected from the geriatrics department of the second affiliated Hospital of Chongqing Medical University from May 2013 to November 2014. According to the age, 83 cases (39 males and 44 females, mean 54.99 卤4.18 years old) were divided into young and middle age group (39 males and 44 females, mean 84.06 卤3.51 years old, male 161, female 216, mean 70.01 卤5.87). According to the results of color Doppler ultrasound of lower extremity, the severity of arteriosclerosis was divided into normal group (n = 112, male 29, female 83, mean 62.51 卤7.96 years old), mild sclerosis group (n = 81) (male 23 cases, female 58 cases, mean 68.14 卤8.17 years old). There were 466 cases in moderate sclerosis group (238 males and 228 females, mean 75.65 卤9.49 years old) and 41 cases in severe sclerosis group (29 males and 12 females, mean 81.88 卤7.12 years old). Age, sex, height, weight, smoking history, hypertension history, diabetes history were collected. Body mass index (BMI) = weight / height 2? kg 路m ~ (2), recorded mean systolic blood pressure (SBP) and diastolic blood pressure (DBP), serum triglyceride (TGG), total cholesterol (TCN), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBGG), 2 h postbreakfast blood glucose (2hPBGG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBGG), Glycosylated hemoglobin (HbAlcN), plasma fibrinogen (Fib), creatinine (Cr), uric acid (UAA), hypersensitive C-reactive protein (hs-CRP), ankle brachial index (ABI). The characteristics of LEAD risk factors in different age groups and different severity were compared and the correlation was analyzed. Results: the Logistic regression analysis showed that old age, smoking, history of diabetes, serum uric acid and ankle brachial index were all independent risk factors of lower extremity atherosclerosis. The incidence of severe sclerosclerotic lesions was significantly higher in the elderly group and the elderly group than in the young and middle age group, and the incidence of severe sclerosis in the elderly group was significantly higher than that in the elderly group, while in the elderly group, the incidence of severe sclerosis in the elderly group was significantly higher than that in the elderly group. The rate of severe sclerosis was also higher than that of the aged group (P < 0.01), and the score of the severity of atherosclerosis of lower extremity increased with age (P 0.01). Conclusion: compared with young and middle age, the degree of lower extremity atherosclerosis in the elderly is more serious, age, smoking, diabetes history and ABI are the independent risk factors of lower extremity atherosclerosis, in this study, the severity of lower extremity atherosclerosis is associated with the age. Male, smoking UAA ABI, hypertension history related.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R543.5

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