论文部分内容阅读
目的探讨我国35～64岁人群血清总胆固醇(TC)水平与心血管病(包括急性冠心病事件和急性脑卒中事件)发病危险的关系。方法采用前瞻性队列研究的方法,对1992年建立的11省市35～64岁队列人群共30384人的基线TC水平和1992—2002年发生的急性冠心病事件和急性脑卒中事件的关系进行分析。应用COX比例风险模型对TC水平与心血管病发病危险进行多因素分析。结果(1)以TC<3.64MMOL/L(140MG/DL)组为对照,随着TC水平的增加,缺血性心血管病发病危险呈持续增加变化。(2)TC水平与不同类型的心血管病的关系有所差别:缺血性脑卒中事件发病危险从TC很低水平(<3.64MMOL/L)开始,随着TC水平的增加呈持续上升的变化;而出血性脑卒中事件与TC水平的关系缺乏一致性。多因素分析结果显示:与TC<5.72MMOL/L(220MG/DL)相比,TC≥5.72MMOL/L时急性冠心病发病危险增加74%(RR=1.743,P<0.01),缺血性脑卒中发病危险增加12%(RR=1.119,P>0.05)。(3)在缺血性心血管病事件中,5.9%可归因于高TC血症;其中11.7%的急性冠心病事件和2.9%的急性缺血性脑卒中事件可归因于高TC血症。(4)不同TC水平时,随着合并其他心血管病危险因素个数的增加,10年心血管病发病的绝对危险增加。结论从TC低水平<3.64MMOL/L(140MG/DL)开始,随着TC水平的增加缺血性心血管病的发病危险持续上升。应该加强多重危险因素的综合干预,以减少心血管病的综合危险。
Objective To investigate the relationship between serum total cholesterol (TC) and the risk of cardiovascular diseases (including acute coronary syndrome and acute stroke) in 35-64-year-old Chinese population. Methods A prospective cohort study was conducted to analyze the relationship between the baseline TC level of 30 384 cohorts and the acute coronary events and acute stroke events in 1992-2002 established in 1992 in 11 cohorts of 35 provinces in China . The COX proportional hazards model was used to conduct multivariate analysis of TC levels and the risk of cardiovascular disease. Results (1) TC <3.64MMOL / L (140MG / DL) group as a control, with the TC levels increased, the risk of ischemic cardiovascular disease showed a continuous increase in change. (2) The relationship between TC levels and different types of cardiovascular diseases is different: the risk of ischemic stroke incurs a rising trend from very low level of TC (<3.64MMOL / L), with the increase of TC levels Change; and the relationship between hemorrhagic stroke and TC levels is not consistent. Multivariate analysis showed that the risk of acute coronary heart disease was increased by 74% (RR = 1.743, P <0.01) when TC≥5.72MMOL / L compared with TC <5.72MMOL / L The risk of stroke increased by 12% (RR = 1.119, P> 0.05). (3) 5.9% of ischemic cardiovascular events were attributable to hypercholesterolemia; 11.7% of acute coronary events and 2.9% of acute ischemic stroke were attributable to high TC blood disease. (4) With different levels of TC, with the increase of the number of risk factors associated with other cardiovascular diseases, the absolute risk of cardiovascular disease increased in 10 years. Conclusion From the low level of TC <3.64MMOL / L (140MG / DL), the risk of ischemic cardiovascular disease continues to increase with the increase of TC level. Comprehensive interventions for multiple risk factors should be stepped up to reduce the combined risk of cardiovascular disease.