老年下肢动脉硬化闭塞症相关危险因素及临床特点分析
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摘要
目的:回顾性分析老年下肢动脉硬化闭塞症与可能的危险因素如性别、年龄、体重、吸烟、血脂、血糖、血压等的相关性,以筛选出老年下肢动脉硬化闭塞症的主要危险因素。同时分析研究老年下肢动脉硬化闭塞症患者的临床表现及其合并高血压病、糖尿病、冠心病、脑梗塞等的临床特点。方法:以2010年1月-2010年12月收入我院干部病房的老年下肢动脉硬化闭塞症患者60例(病例组)及同期住院的老年非下肢动脉硬化闭塞症患者40例(对照组)为研究对象,采用回顾性病例对照研究方法,用SPSS13.0 for Windows统计软件的非条件Logistic回归模型对老年下肢动脉硬化闭塞症可能的危险因素如性别、年龄、体重、吸烟、血脂、血糖、血压等进行回归分析。用SPSS13.0 for Windows统计软件对两组之间高血压病、糖尿病、冠心病、脑梗塞的患病率及超重、吸烟等情况进行χ2检验,比较分析两组之间的差异。同时记录60例老年下肢动脉硬化闭塞症患者的临床表现情况。
结果:1.单因素非条件Logistic回归分析结果显示年龄、吸烟、低密度脂蛋白胆固醇、糖尿病与老年下肢动脉硬化闭塞症有不同程度的正相关(P<0.05);而性别、超重、甘油三酯、尿酸、高血压两组之间差异无统计学意义。对年龄、吸烟、低密度脂蛋白胆固醇、糖尿病危险因素进行多因素非条件Logistic逐步回归分析结果显示上述危险因素仍被选入,且具有高度危险性(P<0.01)。2.病例组高血压病、糖尿病、冠心病、脑梗塞的患病率及超重率、吸烟率明显高于对照组,差异有统计学意义。3.60例老年下肢动脉硬化闭塞症患者中有临床症状的17例,其中11例表现为间歇跛行,6例为下肢静息痛。
结论:在纳入研究的危险因素中,年龄、吸烟、低密度脂蛋白胆固醇、糖尿病与老年下肢动脉硬化闭塞症密切相关,危险度极高(P<0.01)。老年下肢动脉硬化闭塞症患者大多无明显临床症状,多合并高血压病、糖尿病、冠心病、脑梗塞,而且超重率及吸烟率高。
Objective:By retrospective analyzing relativity between elderly lower extremities atherosclerosis disease and its some risk factors,such as sex,age,we- ight,smoking,lipid,glucose,blood pressure, and so on,screen out dominating risk factors correlated with elderly lower extremities atherosclerosis disease.At the same time,analyze and study clinical character of elderly lower extremities ath- erosclerosis disease which contains clinical symptom and the incidence of hyp- ertensive disease,diabetes,coronary heart disease and cerebral infarction.
Methods: Sixty elderly patients with lower extremities atherosclerosis di- sease is the case.The control is forty elderly patients who are not lower extremi- ties atherosclerosis disease.These patients are from the cadre ward of the first hospital of Jilin University in 2010. A retrospective case-control study is appli- ed to analyze its some risk factors which are sex,age,weight,smoking,lipid,gluc- ose and blood pressure by SPSS 13.0 for Windows statistical software with no- n-conditional Logistic regression model.χ2 test of SPSS 13.0 for Windows statistical software is applied between the two groups of hypertension,diabetes, coronary heart disease,cerebral infarction and the prevalence of overweight,s- moking,etc to compara the differences.Also clinical symptom of sixty elderly patients with lower extremities atherosclerosis disease is recorded.
Results: 1.Single factor non-conditional Logistic regression analysis shows different positive correlation between age,smoking,low-density lipoprot- ein cholesterol,diabetes and elderly lower extremities atherosclerosis disease. But there is no significant difference in gender,overweight,triglycerides,uric ac- id,blood pressure between the two groups.Multivariate non-conditional Logi- stic regression analysis which is applied among age,somking,low-density lipop- rotein cholesterol,diabetes shows that these risk factors are still elected and hig- hly dangerous(P<0.01).2.The prevalence of the case in hypertension,diabetes,coronary heart disease,cerebral infarction overweight and smoking is significa- ntly higher than the control,s.The difference is statistically significant.3.Seve- nteen cases show clinical symptoms in sixty elderly patients with lower extrem- ities atherosclerosis. Intermittent claudication accounts for 11 cases.The remain is rest pain.
Conclusions: Age,smoking,low-density lipoprotein cholesterol,diabetes are closely related to elderly lower extremities atherosclerosis disease and are highly risk(P<0.01). Elderly patients with lower extremities atherosclerosis are mostly subclinical and accompany hypertension,diabetes,coronary heart disease, cerebral infarction.And prevalence of overweight and smoking is higher than the contorl,s.
结果:1.单因素非条件Logistic回归分析结果显示年龄、吸烟、低密度脂蛋白胆固醇、糖尿病与老年下肢动脉硬化闭塞症有不同程度的正相关(P<0.05);而性别、超重、甘油三酯、尿酸、高血压两组之间差异无统计学意义。对年龄、吸烟、低密度脂蛋白胆固醇、糖尿病危险因素进行多因素非条件Logistic逐步回归分析结果显示上述危险因素仍被选入,且具有高度危险性(P<0.01)。2.病例组高血压病、糖尿病、冠心病、脑梗塞的患病率及超重率、吸烟率明显高于对照组,差异有统计学意义。3.60例老年下肢动脉硬化闭塞症患者中有临床症状的17例,其中11例表现为间歇跛行,6例为下肢静息痛。
结论:在纳入研究的危险因素中,年龄、吸烟、低密度脂蛋白胆固醇、糖尿病与老年下肢动脉硬化闭塞症密切相关,危险度极高(P<0.01)。老年下肢动脉硬化闭塞症患者大多无明显临床症状,多合并高血压病、糖尿病、冠心病、脑梗塞,而且超重率及吸烟率高。
Objective:By retrospective analyzing relativity between elderly lower extremities atherosclerosis disease and its some risk factors,such as sex,age,we- ight,smoking,lipid,glucose,blood pressure, and so on,screen out dominating risk factors correlated with elderly lower extremities atherosclerosis disease.At the same time,analyze and study clinical character of elderly lower extremities ath- erosclerosis disease which contains clinical symptom and the incidence of hyp- ertensive disease,diabetes,coronary heart disease and cerebral infarction.
Methods: Sixty elderly patients with lower extremities atherosclerosis di- sease is the case.The control is forty elderly patients who are not lower extremi- ties atherosclerosis disease.These patients are from the cadre ward of the first hospital of Jilin University in 2010. A retrospective case-control study is appli- ed to analyze its some risk factors which are sex,age,weight,smoking,lipid,gluc- ose and blood pressure by SPSS 13.0 for Windows statistical software with no- n-conditional Logistic regression model.χ2 test of SPSS 13.0 for Windows statistical software is applied between the two groups of hypertension,diabetes, coronary heart disease,cerebral infarction and the prevalence of overweight,s- moking,etc to compara the differences.Also clinical symptom of sixty elderly patients with lower extremities atherosclerosis disease is recorded.
Results: 1.Single factor non-conditional Logistic regression analysis shows different positive correlation between age,smoking,low-density lipoprot- ein cholesterol,diabetes and elderly lower extremities atherosclerosis disease. But there is no significant difference in gender,overweight,triglycerides,uric ac- id,blood pressure between the two groups.Multivariate non-conditional Logi- stic regression analysis which is applied among age,somking,low-density lipop- rotein cholesterol,diabetes shows that these risk factors are still elected and hig- hly dangerous(P<0.01).2.The prevalence of the case in hypertension,diabetes,coronary heart disease,cerebral infarction overweight and smoking is significa- ntly higher than the control,s.The difference is statistically significant.3.Seve- nteen cases show clinical symptoms in sixty elderly patients with lower extrem- ities atherosclerosis. Intermittent claudication accounts for 11 cases.The remain is rest pain.
Conclusions: Age,smoking,low-density lipoprotein cholesterol,diabetes are closely related to elderly lower extremities atherosclerosis disease and are highly risk(P<0.01). Elderly patients with lower extremities atherosclerosis are mostly subclinical and accompany hypertension,diabetes,coronary heart disease, cerebral infarction.And prevalence of overweight and smoking is higher than the contorl,s.
引文
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[6]武阳丰,马冠生,胡永华,等.中国居民的超重和肥胖流行现状[J].中华预防医学杂志,2005,39(5):316-320.
[7]孙晓燕,李拥军.肥胖与动脉粥样硬化[J].临床荟萃,2009,24(16):1470- 1472.
[8]钟华荣,吕安康,沈卫峰.从分子机制探讨肥胖致动脉粥样硬化[J].国际心血管病杂志,2007,34(5):327-330.
[9] Susan EW, Laura LG, MitchellSW. Adipose tissue: The new endocrine organ? A review article[ J]. Dig Dis Sci ,2009,54 (9):1847-1857.
[10]Stofkova A.Resistin and visfatin: regulators of insulin sens itiv ity,inf lam-mation and immunity[ J].Endocr Regul ,2010,44(1):25-36.
[11]张丽平.代谢综合征与脑血管病[J].中国实用医药,2009,4(13):230-23 2.
[12]李素敏.弱氧化型低密度脂蛋白的致动脉粥样硬化作用[J].中国动脉硬化杂志,2002,10(3): 271-274.
[13]朱晔斌,吴双,孔麟麟,等.氧化型低密度脂蛋白的形成及其致动脉粥样硬化的机制[J].武警医学院学报,2009,18(11):62-64.
[14]雷蕾.老年高血压病患者血尿酸、血液流变学与血脂水平的观察[J].贵州医药,2009,33(8):708-709.
[15]彭涛,王大鹏.代谢综合征患者发生外周血管病变的危险因素[J].实用糖尿病杂志,2008,4(4):7-9.
[16]陈灏珠.实用内科学[M].北京:人民卫生出版社,2008:1460.
[17]管珩,刘志民,李光伟,等.50岁以上糖尿病人群周围动脉闭塞性疾病相关因素分析[J].中华医学杂志,2007,87(1):23-27.
[18]金文胜,潘长玉,陆菊明,等.葡萄糖耐量低减与动脉粥样硬化[J].中华内分泌代谢杂志,2004,20:136-139.
[19]Theodore Mazzone,Alan Chait,Jorge Plutzky.2型糖尿病心血管疾病风险的机制研究[J].世界临床医学,2008,2(9):795-796.
[20]金文胜,潘长玉,陆菊明,等.血糖与动脉粥样硬化的相关研究[J].中华糖尿病杂志,2005, 13(1):19-22.
[21]褚现明,李冰,安毅,等.炎症与动脉粥样硬化关系研究进展[J].中国分子心脏病学杂志,2010,11(3):186-188.
[22]张全贵,张莉.动脉粥样硬化的炎症机制[J].中国动脉硬化杂志,2007, 15(7):521.
[23]李建军.炎症可能是高血压致动脉粥样硬化的重要机制[J].中国循环杂志,2007,22(2): 157-158.
[24]刘爱学,王蕴,吴颖,等.高血压患者动脉粥样硬化相关因素分析[J].现代预防医学,2008, 35(21):4312-4315.
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