本文選題：老年人 + 下肢動脈粥樣硬化��； 參考：《重慶醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：探討老年人下肢動脈粥樣硬化的特點及與心血管危險因素的相關(guān)性,并比較不同程度動脈粥樣硬化危險因素的分布特點,探討其高危因素,為其臨床防治提供依據(jù)。方法：連續(xù)選取重慶醫(yī)科大學(xué)附屬第二醫(yī)院老年病科2013年5月至2014年11月行下肢動脈彩超檢查的住院患者共計700例。根據(jù)年齡分為青中年組(42～59歲)83例,男39例,女44例,平均54.99±4.18歲；老年組(60～79歲)377例,男161例,女216例,平均70.01±5.87歲；高齡老年組(80～100歲)240例,男119例,女121例,平均84.06±3.51歲。根據(jù)下肢動脈彩超結(jié)果進行嚴(yán)重程度評分,將動脈硬化嚴(yán)重程度分為正常組112例(男29例,女83例),平均62.51±7.96歲,輕度硬化組81例(男23例,女58例),平均68.14±8.17歲,中度硬化組466例(男238例,女228例),平均75.65±9.49歲,重度硬化組41例(男29例,女12例),平均81.88±7.12歲。采集入選患者的年齡、性別、身高、體重、吸煙史、高血壓病史、糖尿病史,體質(zhì)指數(shù)(BMI)=體重/身高2(kg/m2),記錄全天平均收縮壓(SBP)與舒張壓(DBP)、血清甘油三酯(TG)、總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-c)、低密度脂蛋白膽固醇(LDL-c)、空腹血糖(FBG)、早餐后2h血糖(2hPBG)、糖化血紅蛋白(HbAlc)、血漿纖維蛋白原(Fib)、肌酐(Cr)、尿酸(UA)、超敏C反應(yīng)蛋白(hs-CRP)、踝肱指數(shù)(ABI)。比較各年齡層次、不同嚴(yán)重程度LEAD危險因素的特點,并分析其相關(guān)性。結(jié)果：二分類多因素非條件的Logistic回歸分析顯示,高齡、吸煙、糖尿病史、血清尿酸(UA)、踝肱指數(shù)(ABI)是下肢動脈粥樣硬化的獨立危險因素(p均0.05)；有序多分類Logistic回歸分析顯示,高齡、男性、吸煙、UA、ABI、高血壓病史與動脈硬化嚴(yán)重程度相關(guān)(p均0.05)；與青中年組相比,老年組、高齡老年組中、重度硬化病變率明顯較高；高齡老年組中、重度硬化病變率亦較老年組高(p均0.01)；隨著增齡,下肢動脈粥樣硬化嚴(yán)重程度評分升高(p0.01)。結(jié)論：與青中年相比,老年人下肢動脈粥樣硬化程度較重；增齡、吸煙、糖尿病史、UA、ABI是下肢動脈粥樣硬化的獨立危險因素；本研究中,下肢動脈粥樣硬化嚴(yán)重程度與高齡、男性、吸煙、UA、ABI、高血壓病史相關(guān)。
[Abstract]:Objective: to investigate the characteristics of lower extremity atherosclerosis and its correlation with cardiovascular risk factors in the elderly, and to compare the distribution characteristics of risk factors of atherosclerosis of different degrees, and to explore the high risk factors of atherosclerosis in order to provide the basis for clinical prevention and treatment. Methods: a total of 700 inpatients were selected from the geriatrics department of the second affiliated Hospital of Chongqing Medical University from May 2013 to November 2014. According to the age, 83 cases (39 males and 44 females, mean 54.99 鹵4.18 years old) were divided into young and middle age group (39 males and 44 females, mean 84.06 鹵3.51 years old, male 161, female 216, mean 70.01 鹵5.87). According to the results of color Doppler ultrasound of lower extremity, the severity of arteriosclerosis was divided into normal group (n = 112, male 29, female 83, mean 62.51 鹵7.96 years old), mild sclerosis group (n = 81) (male 23 cases, female 58 cases, mean 68.14 鹵8.17 years old). There were 466 cases in moderate sclerosis group (238 males and 228 females, mean 75.65 鹵9.49 years old) and 41 cases in severe sclerosis group (29 males and 12 females, mean 81.88 鹵7.12 years old). Age, sex, height, weight, smoking history, hypertension history, diabetes history were collected. Body mass index (BMI) = weight / height 2? kg 路m ~ (2), recorded mean systolic blood pressure (SBP) and diastolic blood pressure (DBP), serum triglyceride (TGG), total cholesterol (TCN), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBGG), 2 h postbreakfast blood glucose (2hPBGG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBGG), Glycosylated hemoglobin (HbAlcN), plasma fibrinogen (Fib), creatinine (Cr), uric acid (UAA), hypersensitive C-reactive protein (hs-CRP), ankle brachial index (ABI). The characteristics of LEAD risk factors in different age groups and different severity were compared and the correlation was analyzed. Results: the Logistic regression analysis showed that old age, smoking, history of diabetes, serum uric acid and ankle brachial index were all independent risk factors of lower extremity atherosclerosis. The incidence of severe sclerosclerotic lesions was significantly higher in the elderly group and the elderly group than in the young and middle age group, and the incidence of severe sclerosis in the elderly group was significantly higher than that in the elderly group, while in the elderly group, the incidence of severe sclerosis in the elderly group was significantly higher than that in the elderly group. The rate of severe sclerosis was also higher than that of the aged group (P < 0.01), and the score of the severity of atherosclerosis of lower extremity increased with age (P 0.01). Conclusion: compared with young and middle age, the degree of lower extremity atherosclerosis in the elderly is more serious, age, smoking, diabetes history and ABI are the independent risk factors of lower extremity atherosclerosis, in this study, the severity of lower extremity atherosclerosis is associated with the age. Male, smoking UAA ABI, hypertension history related.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R543.5

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