本文選題：動(dòng)脈粥樣硬化　切入點(diǎn)：心血管疾病　出處：《天津醫(yī)科大學(xué)》2013年博士論文

【摘要】：背景：細(xì)顆粒物(Fine Particulate Matter, PM2.5)室外濃度已經(jīng)證實(shí)與心血管疾病有聯(lián)系。PM2.5暴露的效應(yīng)有可能是因?yàn)镻M的化學(xué)成分而造成的。 目的：探討PM2.5及其化學(xué)成分對(duì)亞臨床心血管效應(yīng)的作用。 方法：使用“動(dòng)脈粥樣硬化多種族研究隊(duì)列(Multi-Ethnic Study of Atherosclerosis[MESA]))基線資料(2000年-2002年)進(jìn)行橫斷面分析,PM2.5及其化學(xué)成分(元素碳elemental carbon [EC]［有機(jī)碳o(jì)rganic carbon [OC]］硅[silicon]和硫[sulfur])與動(dòng)脈粥樣硬化亞臨床指標(biāo),冠狀動(dòng)脈鈣化(coronary artery calcium [CAC]),和頸動(dòng)脈中層厚度(carotid intima-media thickness [CIMT])之間的聯(lián)系。研究對(duì)象由6,256名45-84歲未患臨床心血管疾病的成人組成。使用3種方法估計(jì)PM成分暴露濃度：1)最近監(jiān)測(cè)點(diǎn)(首要方法)；2)反距離權(quán)重法(Inverse Distance Weighting, IDW);3)城市內(nèi)部平均值。分別使用B超和CT檢測(cè)CIMT和CAC,依據(jù)以往的研究結(jié)果,結(jié)合調(diào)查問卷獲取的相關(guān)協(xié)變量信息,分析PM2.5及其成分與亞臨床心血管疾病的關(guān)系。 結(jié)果：最近監(jiān)測(cè)點(diǎn)估計(jì)暴露時(shí),OC與CIMT的聯(lián)系有統(tǒng)計(jì)學(xué)意義,但是與PM2.5、EC、silicon和sulfur的聯(lián)系沒有統(tǒng)計(jì)學(xué)意義。在其他方法估計(jì)暴露時(shí)也觀察到了某些聯(lián)系,尤其是silicon,盡管這種聯(lián)系并不是始終如一的。未見PM2.5及其化學(xué)成分與CAC(是否存在冠狀動(dòng)脈鈣化或者冠狀動(dòng)脈鈣化的程度)的聯(lián)系。敏感性分析中,某些結(jié)果對(duì)研究城市的調(diào)整比較敏感。 結(jié)論：主要方法(最近監(jiān)測(cè)點(diǎn)和Model1)估計(jì)的OC與CIMT的增加之間的聯(lián)系有統(tǒng)計(jì)學(xué)意義;同時(shí),使用第二種方法(IDW),OC與CIMT也存在著有統(tǒng)計(jì)學(xué)意義的聯(lián)系。PM2.5化學(xué)成分的組成對(duì)PM暴露對(duì)動(dòng)脈粥樣硬化的效應(yīng)是一個(gè)重要的因素。
[Abstract]:Background: fine Particulate matter (PM2.5) outdoor concentrations have been shown to be associated with cardiovascular disease. The effects of PM2.5 exposure may be due to the chemical composition of PM. Objective: to investigate the effects of PM2.5 and its chemical constituents on subclinical cardiovascular effects. Methods: the baseline data of "Multi-Ethnic Study of Atherosclerosis [MESA]" (2000-2002) were used for cross-sectional analysis of PM2.5 and its chemical constituents (elemental elemental carbon [EC] [organic organic carbon [OC] Si [silicon] and sulfur [sulfur]) and atherosclerosis. Sclerosing subclinical index, The association between coronary artery calcium [CAC] and carotid medial thickness intima-media thickness [CIMT]. The subjects were 6256 adults aged 45-84 years without clinical cardiovascular disease. Three methods were used to estimate PM component exposure concentration: 1) recently. The average value of city interior is measured by inverse Distance weighting (IDWX 3) using B-ultrasound and CT, respectively, according to the results of previous studies. The relationship between PM2.5 and its components and subclinical cardiovascular diseases was analyzed by using the covariate information obtained from the questionnaire. Results: the association of OC with CIMT was statistically significant at the most recent monitoring site estimation, but there was no significant association with PM2.5 CIMT and sulfur. Some associations were also observed at the time of exposure estimation by other methods. Silicon, in particular, although the association is not consistent. There is no association between PM2.5 and its chemical constituents (whether or not coronary artery calcification exists or the extent of coronary calcification). Some of the results are sensitive to the adjustment of the study city. Conclusion: there is a statistically significant correlation between the OC estimated by the main methods (the nearest monitoring point and Model1) and the increase in CIMT; at the same time, Using the second method, there was also a significant relationship between CIMT and IDWN OC. The composition of PM2.5 was an important factor in the effect of PM exposure on atherosclerosis.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2013
【分類號(hào)】：R543.5;R122

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本文編號(hào)：1680350