【摘要】：目的比較2011年《中國心血管病預防指南》提出的國人缺血性心血管疾病(CVD)10年發(fā)病危險評估方案(國人評估法)與2013年美國心臟病學會/美國心臟協(xié)會(ACC/AHA)推薦的匯總隊列動脈粥樣硬化性心血管病(ASCVD)風險公式(匯總隊列公式)對健康體檢人群CVD風險的評估價值,以期找到可更準確評估該人群CVD風險的方法。方法選取2016年4—9月在首都醫(yī)科大學附屬北京朝陽醫(yī)院健康體檢中心行健康體檢者733例,年齡40~79歲,既往無CVD。分別應用國人評估法與匯總隊列公式評估所有體檢者10年CVD絕對風險。以頸動脈粥樣硬化斑塊作為CVD的替代指標,間接反映兩種評估方法對該人群CVD絕對風險的評估價值。結(jié)果匯總隊列公式評估體檢者10年CVD絕對風險高于國人評估法[3.6%(6.6%)比1.5%(3.4%)],差異有統(tǒng)計學意義(Z=-19.122,P0.05)。將10年CVD風險7.5%定義為低危組,10年CVD風險≥7.5%定義為非低危組,國人評估法與匯總隊列公式低危組檢出率分別為94.1%(690/733)、73.1%(536/733),非低危組檢出率分別為5.9%(43/733)、26.9%(197/733);兩種評估方法對是否非低危組評估一致性比較,差異有統(tǒng)計學意義(χ~2=146.306,P0.05)。將頸動脈粥樣硬化斑塊作為CVD的替代指標,匯總隊列公式評估體檢者10年CVD絕對風險的受試者工作特征(ROC)曲線下面積(AUC)大于國人評估法{0.770[95%CI(0.738,0.800)]比0.717[95%CI(0.683,0.749)]},差異有統(tǒng)計學意義(Z=3.935,P0.05)。結(jié)論匯總隊列公式較國人評估法可更準確評估健康體檢人群頸動脈粥樣硬化斑塊,從而間接說明可更準確評估該人群CVD 10年風險。提示匯總隊列公式可應用于臨床實踐,早期識別高危人群,促進CVD一級預防。
[Abstract]:Objective to compare the ten year risk assessment program for ischemic cardiovascular disease (CVD) proposed by the Chinese guidelines for the Prevention of Cardiovascular Diseases in China in 2011 (Chinese assessment method) and those recommended by the American Heart Association / American Heart Association (ACC/AHA) in 2013. The value of (ASCVD) risk formula (summary cohort formula) in assessing the risk of CVD in healthy people with atherosclerotic cardiovascular disease in general cohort. In order to find a more accurate method to assess the CVD risk in this population. Methods 733 patients (40 ~ 79 years old), aged 40 to 79 years, who underwent health examination in Beijing Chaoyang Hospital affiliated to Capital Medical University from April to September 2016 were selected. The absolute risk of 10 years CVD was evaluated by Chinese evaluation method and summary cohort formula. Carotid atherosclerotic plaque was used as an alternative index of CVD to indirectly reflect the value of two evaluation methods in assessing the absolute risk of CVD in this population. Results the absolute risk of CVD in the cohort formula was significantly higher than that in the Chinese method [3.6% (6.6%) vs 1.5% (3.4%)], and the difference was statistically significant (P 0.05). The 10-year CVD risk of 7.5% was defined as a low-risk group, and the 10-year CVD risk of 鈮，

本文編號：2180638