JAHA:中国≥40岁居民36.2%颈动脉粥样硬化

2018-04-09 卢芳 中国循环杂志

“中国卒中防治工程“项目组分析了84880名中国居民的颈动脉超声数据,发现中国≥40岁居民中有36.2%颈动脉粥样硬化。


“中国卒中防治工程“项目组分析了84880名中国居民的颈动脉超声数据,发现中国≥40岁居民中有36.2%颈动脉粥样硬化。
 
颈动脉粥样硬化的定义是颈动脉内膜中层厚度(IMT)增厚≥1 mm或存在斑块。研究排除了已接受颈动脉内膜切除术、支架以及有卒中和冠心病的居民。
 
研究中约26.5%居民IMT增加,13.9%居民存在斑块。
 
这个数据远远低于中国慢病前瞻性研究(CKB)31%的斑块患病率。但CKB研究纳入了有卒中(5.4%)和冠心病(7.5%)的患者。
 
作者认为,该研究为最大规模的颈动脉超声筛查研究,证实我国中老年人群普遍存在颈动脉粥样硬化,提醒医生应关注早期动脉粥样硬化,预防动脉粥样硬化性心血管病。
 
农村居民的颈动脉粥样硬化患病率为41.6%,高于城市居民的30.8%。
 
研究者认为这与受教育水平低,以及因经济状况欠佳、医疗资源不均衡等有关。
 
研究还显示,IMT<1 mm的受试者中有8.7%的人颈动脉存在单个或多个粥样斑块。
 
研究者指出,单独测量IMT不足以预测心血管病风险。荟萃分析显示,颈动脉斑块预测心血管病风险准确性更高。
 
进一步分析发现,老年、男性、家住农村、吸烟、饮酒、体力活动少、肥胖、高血压糖尿病以及血脂异常均是颈动脉粥样硬化的危险因素,而增龄最为密切相关。
 
男性颈动脉粥样硬化比女性更常见。可能是因为男性有更多不良生活习惯,比如很多人都是烟民,很多人都喜欢喝酒。
 
比如,吸烟(包-年)与颈动脉中膜厚度、粥样斑块形成呈剂量依赖关系,
 
研究中男性占46.4%,平均年龄60.7岁。
 
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    2018-04-11 zhaohui6731
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    2018-04-10 wzb521zf

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