国人评估法与汇总队列公式对健康体检人群心血管疾病风险评估价值的比较研究
发布时间：2018-08-13 09:58
【摘要】：目的比较2011年《中国心血管病预防指南》提出的国人缺血性心血管疾病(CVD)10年发病危险评估方案(国人评估法)与2013年美国心脏病学会/美国心脏协会(ACC/AHA)推荐的汇总队列动脉粥样硬化性心血管病(ASCVD)风险公式(汇总队列公式)对健康体检人群CVD风险的评估价值,以期找到可更准确评估该人群CVD风险的方法。方法选取2016年4—9月在首都医科大学附属北京朝阳医院健康体检中心行健康体检者733例,年龄40~79岁,既往无CVD。分别应用国人评估法与汇总队列公式评估所有体检者10年CVD绝对风险。以颈动脉粥样硬化斑块作为CVD的替代指标,间接反映两种评估方法对该人群CVD绝对风险的评估价值。结果汇总队列公式评估体检者10年CVD绝对风险高于国人评估法[3.6%(6.6%)比1.5%(3.4%)],差异有统计学意义(Z=-19.122,P0.05)。将10年CVD风险7.5%定义为低危组,10年CVD风险≥7.5%定义为非低危组,国人评估法与汇总队列公式低危组检出率分别为94.1%(690/733)、73.1%(536/733),非低危组检出率分别为5.9%(43/733)、26.9%(197/733);两种评估方法对是否非低危组评估一致性比较,差异有统计学意义(χ~2=146.306,P0.05)。将颈动脉粥样硬化斑块作为CVD的替代指标,汇总队列公式评估体检者10年CVD绝对风险的受试者工作特征(ROC)曲线下面积(AUC)大于国人评估法{0.770[95%CI(0.738,0.800)]比0.717[95%CI(0.683,0.749)]},差异有统计学意义(Z=3.935,P0.05)。结论汇总队列公式较国人评估法可更准确评估健康体检人群颈动脉粥样硬化斑块,从而间接说明可更准确评估该人群CVD 10年风险。提示汇总队列公式可应用于临床实践,早期识别高危人群,促进CVD一级预防。
[Abstract]:Objective to compare the ten year risk assessment program for ischemic cardiovascular disease (CVD) proposed by the Chinese guidelines for the Prevention of Cardiovascular Diseases in China in 2011 (Chinese assessment method) and those recommended by the American Heart Association / American Heart Association (ACC/AHA) in 2013. The value of (ASCVD) risk formula (summary cohort formula) in assessing the risk of CVD in healthy people with atherosclerotic cardiovascular disease in general cohort. In order to find a more accurate method to assess the CVD risk in this population. Methods 733 patients (40 ~ 79 years old), aged 40 to 79 years, who underwent health examination in Beijing Chaoyang Hospital affiliated to Capital Medical University from April to September 2016 were selected. The absolute risk of 10 years CVD was evaluated by Chinese evaluation method and summary cohort formula. Carotid atherosclerotic plaque was used as an alternative index of CVD to indirectly reflect the value of two evaluation methods in assessing the absolute risk of CVD in this population. Results the absolute risk of CVD in the cohort formula was significantly higher than that in the Chinese method [3.6% (6.6%) vs 1.5% (3.4%)], and the difference was statistically significant (P 0.05). The 10-year CVD risk of 7.5% was defined as a low-risk group, and the 10-year CVD risk of 鈮，
本文编号：2180638
[Abstract]:Objective to compare the ten year risk assessment program for ischemic cardiovascular disease (CVD) proposed by the Chinese guidelines for the Prevention of Cardiovascular Diseases in China in 2011 (Chinese assessment method) and those recommended by the American Heart Association / American Heart Association (ACC/AHA) in 2013. The value of (ASCVD) risk formula (summary cohort formula) in assessing the risk of CVD in healthy people with atherosclerotic cardiovascular disease in general cohort. In order to find a more accurate method to assess the CVD risk in this population. Methods 733 patients (40 ~ 79 years old), aged 40 to 79 years, who underwent health examination in Beijing Chaoyang Hospital affiliated to Capital Medical University from April to September 2016 were selected. The absolute risk of 10 years CVD was evaluated by Chinese evaluation method and summary cohort formula. Carotid atherosclerotic plaque was used as an alternative index of CVD to indirectly reflect the value of two evaluation methods in assessing the absolute risk of CVD in this population. Results the absolute risk of CVD in the cohort formula was significantly higher than that in the Chinese method [3.6% (6.6%) vs 1.5% (3.4%)], and the difference was statistically significant (P 0.05). The 10-year CVD risk of 7.5% was defined as a low-risk group, and the 10-year CVD risk of 鈮，
本文编号：2180638
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