【摘要】：目的:本研究對(duì)不同性別35-59歲無(wú)規(guī)律運(yùn)動(dòng)人群未來(lái)10年發(fā)生缺血性心血管事件(ICVD)的絕對(duì)危險(xiǎn)度進(jìn)行評(píng)估,分析不同性別對(duì)35-39歲、40-44歲、45-49歲、50-54歲、55-59歲五個(gè)不同年齡段人群未來(lái)10年發(fā)生ICVD絕對(duì)危險(xiǎn)度的影響程度及相關(guān)性,各危險(xiǎn)因素尤其是性別因素與35-59歲人群未來(lái)10年發(fā)生ICVD絕對(duì)危險(xiǎn)度的相關(guān)程度,為早期實(shí)施預(yù)防和治療提供依據(jù),對(duì)于減少缺血性心血管事件的患病率和死亡率具有現(xiàn)實(shí)意義。方法:隨機(jī)選取西安市373名不同性別無(wú)規(guī)律運(yùn)動(dòng)人群為研究對(duì)象,其中男性受試者160名,女性受試者213名。采用國(guó)家“十五”攻關(guān)課題組所開發(fā)的“國(guó)人缺血性心血管病十年發(fā)病危險(xiǎn)評(píng)估方法”對(duì)體檢所得的血壓、血脂、血糖、體質(zhì)指數(shù)等危險(xiǎn)因素進(jìn)行分析評(píng)價(jià),對(duì)男女各危險(xiǎn)因素做獨(dú)立樣本t檢驗(yàn),并以各危險(xiǎn)因素為自變量,絕對(duì)危險(xiǎn)度為因變量再分別進(jìn)行線性相關(guān)分析和多元回歸分析。結(jié)果:(1)流行病學(xué)情況:各危險(xiǎn)因素平均水平男女分別為:年齡(46.88±7.31、46.42±7.10);BMI(25.14±3.12 Kg/m2、23.71±3.55 Kg/m2);SBP(119.79±13.38 mmHg、109.93±14.22 mm Hg);DBP(79.89±9.36mmHg、71.30±9.24mm Hg);腰圍(89.18±9.57cm、83.01±8.70 cm);臀圍(95.02±5.92cm、94.13±6.16cm);FBG(4.61±1.42mmol/L、4.53±1.53mmol/L);WHR(0.94、0.88);TG(1.82±1.12mmol/L、1.27±0.79 mmol/L);HDL-C(1.25±0.31mmol/L、1.48±0.35mmol/L);LDL-C(3.01±0.779mmol/L、2.94±0.77mmol/L);TC(4.66±0.82mmol/L、4.64±0.83 mmol/L)。各危險(xiǎn)因素男女異常指標(biāo)所占百分比為:SBP≥130mm Hg(男29.38㳠、女14.55㳠);DBP≥85mmHg(男33.13㳠、女8.45㳠);FBG≥7.0mmol/L(男4.38㳠、女3.29㳠);TG≥1.7mmol/L(男43.75㳠、女15.49㳠);HDL-C1.04mmol/L(男25.63㳠、女9.39㳠);LDL-C≥3.37mmol/L(男30.00㳠、女27.23㳠);TC≥5.18mmol/L(男25.00㳠、女24.41㳠);BMI≥25(男49.38㳠、女28.64㳠);吸煙者(男62.50㳠、女8.45㳠)。(2)各年齡段(35-39歲、40-44歲、45-49歲、50-54歲、55-59歲)人群未來(lái)10年發(fā)生ICVD絕對(duì)危險(xiǎn)度分別為:男性(0.99、1.34、2.60、2.94、4.03),其中男性45-49歲、50-54歲、55-59歲年齡段絕對(duì)危險(xiǎn)高于國(guó)人平均危險(xiǎn);女性(0.19、0.35、0.58、1.30、2.36),其中50-54歲和55-59歲年齡段絕對(duì)危險(xiǎn)高于國(guó)人參考標(biāo)準(zhǔn)。除55-59歲年齡段10年發(fā)生ICVD絕對(duì)危險(xiǎn)度不同性別有顯著性差異(P0.05)外,余下各年齡段不同性別比較均有非常顯著性差異(P0.01)。(3)男性無(wú)規(guī)律運(yùn)動(dòng)人群ICVD絕對(duì)危險(xiǎn)度構(gòu)成比檢出情況:危險(xiǎn)度5㳠為88.90㳠;5㳠≤危險(xiǎn)度10㳠為10.10㳠;10㳠≤危險(xiǎn)度20㳠的為0.60㳠,危險(xiǎn)度≥20㳠的為0.6㳠。女性無(wú)規(guī)律運(yùn)動(dòng)人群ICVD絕對(duì)危險(xiǎn)度構(gòu)成比檢出情況:危險(xiǎn)度5㳠為98.6㳠;5㳠≤危險(xiǎn)度10㳠為0.5㳠;10㳠≤危險(xiǎn)度20㳠的人群為0.9㳠。(4)35-59歲年齡段不同性別無(wú)規(guī)律運(yùn)動(dòng)人群各危險(xiǎn)因素與未來(lái)10年發(fā)生ICVD絕對(duì)危險(xiǎn)度的相關(guān)程度較高且具有顯著性,其相關(guān)系數(shù)β值與P值分別為:男性人群:35-39歲人群(血壓:β=0.331,P=0.000;吸煙:β=0.297,P=0.000;血脂:β=0.289,P=0.045);40-44歲人群(血壓:β=0.425,P=0.000;BMI:β=0.315,P=0.000;吸煙:β=0.309,P=0.000);45-49歲人群(血壓:β=1.463,P=0.000);50-54歲人群(血糖:β=1.179,P=0.043;血脂:β=0.844,P=0.039;血壓:β=0.782,P=0.000;吸煙:β=0.745,P=0.000;BMI:β=0.726,P=0.009);55-59歲人群(血糖:β=1.903,P=0.000;BMI:β=1.058,P=0.000;血壓:β=1.050,P=0.000;吸煙:β=1.010,P=0.005;血脂:β=0.929,P=0.008)。女性人群:35-39歲人群(血壓:β=0.167,P=0.000);40-44歲人群(血壓:β=0.338,P=0.000);45-49歲人群(血脂:β=0.299,P=0.005;血壓:β=0.289,P=0.000);50-54歲人群(吸煙:β=0.982,P=0.001;血糖:β=0.769,P=0.000;血壓:β=0.528,P=0.000;血脂:β=0.453,P=0.008);55-59歲人群(吸煙:β=2.343,P=0.000,血糖:β=1.918,P=0.000;血脂:β=0.867,P=0.042;血壓:β=0.864,P=0.000)。(5)就整體而言,不同性別無(wú)規(guī)律運(yùn)動(dòng)人群各危險(xiǎn)因素與10年發(fā)生ICVD的危險(xiǎn)度相關(guān)程度從高到低分別為:男性(血糖:β=2.046,P=0.001;血壓:β=0.943,P=0.000;年齡:β=0.664,P=0.000;吸煙:β=0.663,P=0.000)。女性(血糖:β=1.496,P=0.000;吸煙:β=1.432,P=0.000;血脂:β=0.506,P=0.000;血壓:β=0.462,P=0.000;BMI:β=0.279 P=0.000;年齡:β=0.227 P=0.000)。結(jié)論:(1)以性別分組來(lái)看,各危險(xiǎn)因素與10年發(fā)生ICVD的絕對(duì)危險(xiǎn)相關(guān)程度由高到低依次為:男(血糖、血壓、年齡、吸煙);女性(血糖、吸煙、血脂、血壓、BMI、年齡)。(2)不同性別無(wú)規(guī)律運(yùn)動(dòng)人群除BMI、腰圍、臀圍、腰臀比高于正常范圍外,血壓、血糖、血脂四項(xiàng)(僅男性TG高于正常)等危險(xiǎn)因素均在正常范圍。(3)隨著年齡增長(zhǎng),不同性別人群未來(lái)10年發(fā)生ICVD絕對(duì)危險(xiǎn)度的平均水平整體呈上升趨勢(shì)。男性無(wú)規(guī)律運(yùn)動(dòng)人群45-49歲、50-54歲及55-59歲年齡段人群未來(lái)10年發(fā)生ICVD的絕對(duì)危險(xiǎn)均高于國(guó)人平均危險(xiǎn);女性無(wú)規(guī)律運(yùn)動(dòng)人群50-54歲及55-59歲這兩個(gè)年齡段人群未來(lái)10年發(fā)生ICVD的絕對(duì)危險(xiǎn)度均高于國(guó)人平均危險(xiǎn)。(4)男性無(wú)規(guī)律運(yùn)動(dòng)人群未來(lái)10年發(fā)生ICVD的絕對(duì)危險(xiǎn)度均大于女性,即未來(lái)10年男性無(wú)規(guī)律運(yùn)動(dòng)人群罹患心血管疾病的風(fēng)險(xiǎn)要高于女性。(5)以五個(gè)年齡段分層來(lái)看,各危險(xiǎn)因素與10年發(fā)生ICVD絕對(duì)危險(xiǎn)度的相關(guān)程度由高到低分別為:(1)35-39歲:男性為血壓、吸煙、血脂;女性為血壓;(2)40-44歲:男性為血壓、BMI、吸煙;女性為血壓;(3)45-49歲:男性為血壓,女性為血脂、血壓;(4)50-54歲:男性為血糖、血脂、血壓、吸煙、BMI,女性為吸煙、血糖、血壓、血脂;(5)55-59歲:男性為血糖、BMI、血壓、吸煙、血脂,女性為吸煙、血糖、血脂、血壓。由此可以推測(cè),血壓、血糖、吸煙可以作為心血管事件發(fā)生的主要參考指標(biāo),亦可作為心血管事件發(fā)生的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: To evaluate the absolute risk of ischemic cardiovascular events (ICVD) in the next 10 years of 35-59 year olds with different sex, and to analyze the degree and correlation of the influence of different sex on the absolute risk of ICVD in the next 10 years of 35-39, 40-44, 45-49, 50-54 and 55-59 years old and five different age groups. The correlation between the risk factors, especially the sex factors and the absolute risk of ICVD in the 35-59 year old population in the next 10 years, provides the basis for the early implementation of prevention and treatment, and is of practical significance for reducing the morbidity and mortality of ischemic cardiovascular events. Methods: 373 people with different sex irregular movements in Xi'an were selected randomly. The subjects were 160 male subjects and 213 female subjects. The risk factors, such as blood pressure, blood lipid, blood sugar and body mass index, were analyzed and evaluated by the national "fifteen" group of "fifteen" task group. The risk factors of blood pressure, blood lipid, blood sugar and body mass index were evaluated, and the independent sample of the risk factors of men and women was t. The results were: (1) the average levels of the risk factors were: age (46.88 + 7.31,46.42 + 7.10), BMI (25.14 + 3.12 Kg/m2,23.71 + 3.55 Kg/m2), SBP (119.79 + 13.38 mmHg, 109.93 +, 109.93 +), respectively. 14.22 mm Hg), DBP (79.89 + 9.36mmHg, 71.30 + 9.24mm Hg), waist circumference (89.18 + 9.57cm, 83.01 + 8.70 cm), hip circumference (95.02 + 5.92cm, 94.13 + 6.16cm), FBG (4.61 + 1.42mmol/L, 4.53 + 83.01); TC (4.66 + 0.82mmol/L, 4.64 + 0.83 mmol/L). The percentage of abnormal indicators of male and female risk factors: SBP > 130mm Hg (male 29.38?, female 14.55?); DBP more than 85mmHg (male 33.13?, female 8.45?); FBG > 7.0mmol/L (men 4.38?, 3.29?); TG > 1.7mmol/ (male 43.75, 15.49?); male 25.63? Female 9.39?) Female 27.23?); TC > 5.18mmol/L (male 25?, female 24.41?); BMI > 25 (male 49.38, female 28.64?); smokers (62.50 men, 8.45?). (2) each age group (35-39, 40-44 years, 45-49, 50-54 years, 55-59 years old) in the future, the risk of male (0.99,1.34,2.60,2.94,4.03), male (0.99,1.34,2.60,2.94,4.03) The absolute risk of the segment was higher than the national average risk; women (0.19,0.35,0.58,1.30,2.36), of which the absolute risk of 50-54 and 55-59 years old was higher than the national reference standard. There were significant differences in the absolute risk of ICVD in the 55-59 year old age group (P0.05). (P0.01). (3) the ICVD absolute risk constitution ratio detection of male irregular movement population: risk degree 5? 88.90?; 5? (10?) risk degree 10?; 10? (20?), 0.60? The risk factors of 20? (4) were 0.9? (4) the risk factors of different sex unregulated groups in the age group of 35-59 years were higher and significantly correlated with the absolute risk of ICVD in the next 10 years. The correlation coefficient beta and P were: the male population: the 35-39 year old group (blood pressure: beta =0.331, P=0.000; smoking: beta =0.297, P=0.000; blood lipid: Beta =0.289, P=0.045); 40-44 year old people (blood pressure: beta =0.425, P=0.000; BMI: beta =0.315, P=0.000; smoking: beta =0.309, P=0.000); 45-49 years old people (blood pressure: beta =1.463, P=0.000); blood glucose: beta blood pressure: Beta Beta =1.903, P=0.000; BMI: beta =1.058, P=0.000; blood pressure: beta =1.050, P=0.000; smoking: beta =1.010, P=0.005; blood lipids: beta =0.929, P=0.008). Female population (blood pressure: beta =0.167, =1.058); 45-49 year old people (blood pressure: beta blood pressure: beta blood pressure, beta); people (smoking: beta: beta, smoking, beta) P=0.001; blood glucose: beta =0.769, P=0.000; blood pressure: beta =0.528, P=0.000; blood lipid: beta =0.453, P=0.008); 55-59 year old people (smoking: beta =2.343, P=0.000, beta =1.918, P=0.000; beta =0.867, blood pressure, beta). (5) in the whole body, the risk factors of different sex irregular movement groups are related to the risk correlation of 10 years. From high to low, male (blood sugar: beta =2.046, P=0.001; blood pressure: beta =0.943, P=0.000; age: beta =0.664, P=0.000; smoking: beta =0.663, P=0.000). According to the group, the degree of risk factors associated with the absolute risk of ICVD in 10 years from high to low was male (blood sugar, blood pressure, age, smoking); women (blood sugar, smoking, blood lipid, blood pressure, BMI, age). (2) except BMI, waist circumference, hip circumference, waist hip ratio above normal range, blood pressure, blood sugar, blood fat four items (only male) The risk factors such as TG are higher than normal. (3) as the age increases, the average level of the absolute risk of ICVD in the next 10 years of the different sexes is rising. The male irregular movement population is 45-49 years old, and the absolute risk of the occurrence of ICVD in the 50-54 and 55-59 year olds is higher than the average risk of the people in the next 10 years. The absolute risk of ICVD in the next 10 years of the two age groups of 50-54 and 55-59 years old is higher than the national average risk. (4) the absolute risk of ICVD in the next 10 years of the male irregular movement population is greater than that of the female. That is, the risk of cardiovascular disease in the male irregular movement population in the next 10 years is higher than that in the next 10 years. (5) in five age groups, the correlation between the risk factors and the absolute risk of ICVD in 10 years was from high to low: (1) 35-39 years old: men were blood pressure, smoking, blood lipid; women were blood pressure; (2) 40-44 years old: men were blood pressure, BMI, smoking; women were blood pressure; (3) 45-49 years old: men were blood pressure, women were blood lipids, blood pressure; (4) 50-54 Age: men are blood sugar, blood fat, blood pressure, smoking, BMI, and women are smoking, blood sugar, blood pressure, blood lipid; (5) 55-59 years old: male is blood sugar, BMI, blood pressure, smoking, blood lipid, women are smoking, blood sugar, blood lipid, blood pressure. Thus, it can be speculated that blood pressure, blood sugar, smoking can be the main reference index of cardiovascular events, and may also be used as cardiovascular events. Independent risk factors.
【學(xué)位授予單位】：西安體育學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：G804.49

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