【摘要】：背景與目的:Frank征又名耳垂折痕征,是人群中常見(jiàn)的體表標(biāo)志。既往國(guó)外流行病學(xué)研究發(fā)現(xiàn)Frank征陽(yáng)性者發(fā)生動(dòng)脈粥樣硬化性心血管疾病的風(fēng)險(xiǎn)明顯增高,提示Frank征可能成為早期發(fā)現(xiàn)心血管疾病的一個(gè)線索。但這一特點(diǎn)是否有種族差異尚不清楚,尤其是在中國(guó)漢族人群中Frank征與心血管疾病是否相關(guān)尚缺乏資料。本研究旨在通過(guò)收集分析陜西省人民醫(yī)院心內(nèi)科住院患者的臨床資料及Frank征特點(diǎn),探討中國(guó)漢族人群中Frank征與心血管疾病(冠心病、高血壓病、糖尿病)之間的相關(guān)性,以期為心血管疾病的早期診斷提供簡(jiǎn)單的臨床線索。方法:納入2016年1月到2016年12月期間陜西省人民醫(yī)院心內(nèi)科連續(xù)住院的2000例病人(男性1097人,平均年齡64歲),詳細(xì)記錄其病史及各項(xiàng)生化檢查資料,并由專人判斷Frank征特點(diǎn)并拍照留存,分為Frank征陽(yáng)性組、Frank征陰性組,其中陽(yáng)性標(biāo)準(zhǔn)為雙側(cè)或單側(cè)耳垂折痕長(zhǎng)度大于整個(gè)耳垂的1/3。分別采用卡方檢驗(yàn)比較Frank征陽(yáng)性組與Frank征陰性組的分類變量(高血壓病、糖尿病、冠心病、吸煙史、飲酒史、腎臟病史、性別)之間的差異;T檢驗(yàn)來(lái)分析Frank征陽(yáng)性組與Frank征陰性組的數(shù)值變量(低密度脂蛋白、高密度脂蛋白、甘油三酯及尿酸)的差異;二分類Logistic回歸分析探究Frank征與心血管病的相關(guān)性。結(jié)果:1.Frank征陽(yáng)性組有1092例,其發(fā)生率為54.6%。2.Frank征陽(yáng)性組男性發(fā)生率明顯高于Frank征陰性組男性發(fā)生率(59.9%vs 48.8%),差異有統(tǒng)計(jì)學(xué)意義(P0.001);Frank征陽(yáng)性組平均年齡(68.62±10.49)明顯高于Frank征陰性組平均年齡(59.29±11.92),差異有統(tǒng)計(jì)學(xué)意義(P0.001);Frank征陽(yáng)性組冠心病發(fā)生率明顯高于Frank征陰性組冠心病發(fā)生率(61.4%vs 51.3%),差異有統(tǒng)計(jì)學(xué)意義(P0.001);Frank征陽(yáng)性組高血壓病發(fā)生率明顯高于Frank征陰性組高血壓病發(fā)生率(62.3%vs 54.1%),差異有統(tǒng)計(jì)學(xué)意義(P0.001);Frank征陽(yáng)性組糖尿病發(fā)生率明顯高于Frank征陰性組糖尿病發(fā)生率(28.6%vs 21.1%),差異有統(tǒng)計(jì)學(xué)意義(P0.001)。3.Frank征陽(yáng)性組腎臟病發(fā)生率與Frank征陰性組腎臟病發(fā)生率之間無(wú)統(tǒng)計(jì)學(xué)差異(5.6%vs 5.0%)(P=0.531);Frank征陽(yáng)性組吸煙者與Frank征陰性組吸煙者之間無(wú)統(tǒng)計(jì)學(xué)差異(27.5%vs 24.6%)(P=0.140);Frank征陽(yáng)性組飲酒者與Frank征陰性組飲酒者之間無(wú)統(tǒng)計(jì)學(xué)差異(4.6%vs 4.8%)(P=0.779)。4.Frank征陽(yáng)性組甘油三酯平均值(1.48±0.94)明顯低于Frank征陰性組甘油三酯平均值(1.60±1.00),差異有統(tǒng)計(jì)學(xué)意義(P=0.031);Frank征陽(yáng)性組低密度脂蛋白平均值(2.50±0.82)與Frank征陰性組低密度脂蛋白平均值(2.32±0.96)之間無(wú)統(tǒng)計(jì)學(xué)差異(P=0.183);Frank征陽(yáng)性組高密度脂蛋白平均值(1.53±13.21)與Frank征陰性組高密度脂蛋白平均值(1.14±0.34)之間無(wú)統(tǒng)計(jì)學(xué)差異(P=0.163);Frank征陽(yáng)性組尿酸平均值(329.31±116.34)明顯高于Frank征陰性組尿酸平均值(320.13±100.92),差異有統(tǒng)計(jì)學(xué)意義(P=0.006)。5.非條件二分類回歸分析得到Frank征與年齡、性別、糖尿病、高血壓病、冠心病有顯著相關(guān)性(P=0.000,P=0.000,P=0.035,P=0.024,P=0.008),且Frank征陽(yáng)性患者冠心病發(fā)生率比Frank征陰性患者高1.9倍。結(jié)論:1.心血管及其相關(guān)疾病患者中,Frank征的陽(yáng)性率較高,可達(dá)54.6%,且有性別差異。2.Frank征可作為心血管疾病及其相關(guān)疾病的早期識(shí)別線索,對(duì)于年輕男性患者Frank征預(yù)測(cè)心血管疾病的價(jià)值更大。
[Abstract]:BACKGROUND & OBJECTIVE: Frank's sign, also known as the earlobe crease sign, is a common body surface marker in the population. Prior foreign epidemiological studies have found that there is a marked increase in the risk of atherosclerotic cardiovascular disease in the case of Frank's positive people, suggesting that Frank's sign may be a clue to the early detection of cardiovascular disease. However, it is not clear whether there is a racial difference in this feature, especially whether Frank's sign and cardiovascular disease are still lacking in the Chinese Han population. The purpose of this study is to study the correlation between Frank's sign and cardiovascular disease (coronary heart disease, hypertension, and diabetes) in Chinese Han population by collecting the clinical data and the characteristics of Frank's sign in the patients in the heart of the People's Hospital of Shaanxi Province. in order to provide a simple clinical clue for the early diagnosis of the cardiovascular disease. Methods: In the period from January 2016 to December 2016, 2000 patients (1097 men and 64 years of age) of the Department of Cardiology of the People's Hospital of Shaanxi Province were included, and the medical history and the biochemical examination data were recorded in detail. The Frank sign-negative group, where the positive standard is the double side or one-sided earlobe fold length is greater than 1/ 3 of the total ear lobe. The difference between Frank's positive group and Frank's negative group (hypertension, diabetes, coronary heart disease, smoking history, history of drinking, history of kidney disease, sex) was compared by the card-side test, respectively. T-test was used to analyze the difference between Frank's positive group and Frank's negative group (low density lipoprotein, high-density lipoprotein, triglyceride and uric acid). Results: 1. The incidence of positive group of positive group was 54. 6%. The incidence of male in positive group was higher than that of the negative group of Frank (55.9% vs. 48. 8%), and the difference was statistically significant (P 0.001). The mean age of Frank's positive group was significantly higher than that of Frank's negative group (59. 29, 11.92). The difference was significant (P 0.001). The incidence of coronary heart disease in the positive group of Frank was significantly higher than that of the negative group of Frank (61.4% vs. 51.3%), and the difference was significant (P 0.001). The incidence of hypertension in the positive group of Frank's positive group was significantly higher than that of the negative group of Frank (62.3% vs. 54.1%), and the difference was significant (P 0.001), and the incidence of diabetes in the positive group of Frank's positive group was higher than that of the negative group of Frank (28. 6% vs. 21.1%). There was no statistical difference (P = 0.531) between the incidence of renal disease and the incidence of renal disease in the negative group of the Frank sign (P = 0. 531), and there was no statistical difference between the positive group of the positive group and the negative group of the Frank sign (P = 0.140). There was no statistical difference (4.6% vs. 4.8%) between the positive group and the negative group of Frank (P = 0.779). The mean value of triglyceride (1.48% 0.94) in the positive group was significantly lower than that of the negative group in the negative group (1.60% and 1.00), and the difference was statistically significant (P = 0.031). There was no statistical difference (P = 0.183) between the mean of low-density lipoprotein (2.50-0.82) and the average of low-density lipoprotein (2.32-0.96) in the negative group of Frank-positive group. The mean value of high-density lipoprotein (1.53-13.21) in the positive group and the mean value of high-density lipoprotein (1.14-0.34) in the negative group of the Frank-positive group were not statistically different (P = 0.163), and the average of uric acid (32.9. 31-116. 34) in the positive group of the Frank-positive group was significantly higher than the average of uric acid in the negative group of Frank (33.2. 13-100. 92). The difference was significant (P = 0. 006). There was a significant correlation between Frank's sign and age, sex, diabetes, hypertension and coronary heart disease (P = 0.000, P = 0.000, P = 0. 035, P = 0. 024, P = 0. 008). Conclusion: 1. In the patients with cardiovascular and related diseases, the positive rate of Frank's sign is high, it can reach 54. 6%, and there is a gender difference. 2. Frank's sign can be used as an early identification clue for cardiovascular diseases and related diseases.
【學(xué)位授予單位】：西安醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R54;R764

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