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目的探讨不同地区中老年心脑血管病高危人群的同型半胱氨酸(Hcy)水平、分布特点及主要影响因素,为心脑血管病的早期防治提供依据。方法于2014年3-9月采用多阶段分层整群抽样方法,分别在山东省济南和青岛地区对40岁以上常住居民共计43 528名进行心脑血管病高危人群筛查,并进行问卷调查、体格检测、Hcy及血生化指标测定。筛选出高危人群后,按年龄分为40~、50~、60~、70~和80~岁5个年龄组,应用SPSS 17.0统计软件进行t检验、方差分析、χ~2检验、Spearman相关分析和logistic回归分析,分析两地区不同性别、不同年龄组高危人群Hcy水平、分布和影响因素。结果共调查43 528名,其中高危人群7 661名,占17.6%。济南地区总体、男性、女性Hcy水平[分别为(19.04±8.66)、(21.18±9.98)、(17.15±6.77)μmol/L]均高于青岛地区[分别为(12.17±5.73)、(13.43±6.81)、(11.10±4.34)μmol/L],差异均有统计学意义(P<0.01)。两地区男性Hcy水平均分别高于同地区女性,差异均有统计学意义(P<0.05,P<0.01)。济南各年龄组Hcy水平均高于青岛同年龄组,差异均有统计学意义(P<0.01,P<0.05)。两地区高年龄组男性、女性Hcy水平高于低年龄组,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,年龄(OR=1.03)、性别(OR=0.43)、总胆固醇(OR=1.74)是济南地区高危人群Hcy升高的影响因素(P<0.01),年龄(OR=1.05)、性别(OR=0.42)、甘油三酯(OR=1.41)、低密度脂蛋白胆固醇(OR=1.55)是青岛地区高危人群Hcy升高的影响因素(P<0.01)。结论中老年心脑血管病高危人群的Hcy水平的分布存在明显的地区、年龄、性别间差别。对于高危人群,应定期检查血浆Hcy水平,使其养成良好的生活习惯和健康的饮食习惯,降低血脂水平,以预防心脑血管病的发生。
Objective To investigate the homocysteine (Hcy) levels, distribution characteristics and main influential factors in high risk population of cardio-cerebrovascular disease in different areas and provide basis for early prevention and treatment of cardiovascular and cerebrovascular diseases. METHODS: From March to September 2014, a multistage stratified cluster sampling method was used to screen 43 528 permanent residents above 40 years old in Jinan and Shandong of Shandong Province for risk assessment of cardio-cerebrovascular disease and to conduct questionnaire survey , Physical examination, Hcy and blood biochemical markers. After screening the high-risk groups, the patients were divided into five groups according to their age: 40 ~ 50 ~ 60 ~ 70 ~ and 80 ~ 5 years old. SPSS 17.0 software was used for t test, ANOVA, Chi-square test and Spearman correlation analysis And logistic regression analysis to analyze the Hcy level, distribution and influencing factors of high risk population of different gender and age groups in two regions. Results A total of 43 528 were investigated, of which 7 661 were high-risk people, accounting for 17.6%. In Jinan, overall Hcy levels in males and females were (19.04 ± 8.66), (21.18 ± 9.98) and (17.15 ± 6.77) μmol / L, respectively, higher than those in Qingdao [12.17 ± 5.73 and 13.43 ± 6.81), (11.10 ± 4.34) μmol / L, respectively), the differences were statistically significant (P <0.01). Hcy levels in males in both regions were significantly higher than those in females in both regions (P <0.05, P <0.01). The Hcy levels in all age groups in Jinan were higher than those in the same age group in Qingdao (P <0.01, P <0.05). The Hcy level of male and female in high age group in both regions was higher than that in lower age group, the difference was statistically significant (P <0.05). Multivariate logistic regression analysis showed that age (OR = 1.03), sex (OR = 0.43) and total cholesterol (OR = 1.74) were the risk factors for Hcy in high-risk population in Jinan ), Gender (OR = 0.42), triglyceride (OR = 1.41), and low density lipoprotein cholesterol (OR = 1.55) were the influential factors of Hcy increase in high risk population in Qingdao (P <0.01). Conclusion The distribution of Hcy level in middle-aged and elderly people at high risk of cardiovascular and cerebrovascular diseases has obvious regional, age and gender differences. For high-risk groups, should be regularly checked plasma Hcy levels, to develop good habits and healthy eating habits, reduce blood lipid levels, to prevent the occurrence of cardiovascular and cerebrovascular disease.