摘要
目的:分析10年中沈阳地区铁路职工内科住院患者冠状动脉性心脏病(冠心病)危险因素结构及强度的变化趋势,为早期防治冠心病提供依据。方法:①选择1993/2002沈阳铁路局中心医院心内科住院患者,包括冠心病、风湿性心脏病、高血压、心肌病、心律失常及其他患者。1993/1995组1500例,2000/2002组1500例,调查体质量指数、收缩压、舒张压、血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、吸烟等危险因素结构及强度的变化趋势及与冠心病构成比、住院期间病死率的相关关系。②在沈阳铁路局中心医院,调查2003年内科各科系及体检中心就诊的4900例患者的血脂异常,高血压、吸烟、糖尿病、体质量指数、焦虑状态、血半胱氨酸、脂蛋白(a)、C-反应蛋白、年龄及家族史情况。分析冠心病危险因素的强度、结构与冠心病构成比、住院期间病死率的联系。预测沈阳地区铁路职工心血管事件发病的绝对危险度。结果:1993/1995组1500例,2000/2002组1500例患者全部进入结果分析。2003年来沈阳铁路局中心医院内科就诊的患者4900例全部进入结果分析。①1993/2002冠心病危险因素强度中体质量指数,舒张压、三酰甘油呈显著上升趋势。冠心病危险因素结构排序为:原发性高血压、体质量指数超过标准(肥胖)、高三酰甘油血症、高胆固醇血症、吸烟、糖尿病。②2003年调查资料分析显示:收缩压、舒张压、高三酰甘油血症、高胆固醇血症、吸烟、焦虑、年龄与冠心病构成比呈正相关(r=0.79～0.80,P<0.01)。收缩压、舒张压、焦虑、年龄与冠心病住院期间病死率呈正相关(r=0.71～0.73,P<0.05)。沈阳地区铁路职工心血管事件发病绝对危险度男性为13.2%,女性9.7%。结论:原发性高血压、体质量指数超标、焦虑、高甘油三酯血症、高胆固醇血症、吸烟、糖尿病是沈阳地区铁路职工冠心病危险因素。强度呈上升趋势的危险因素是:高血压(舒张压)、高甘油三酯血症、焦虑。
AIM： To analyze the variational tendency of structure and strength of risk factor of coronary heart disease （CHD） railway workers who hospitalized at department of internal medicine at Shenyang area in 10 years, and supply the basis for preventing CHD early.
METHODS： ①lnpatients, who were treated at Department of Cardiology, Central Hospital, Shenyang Railway Bureau from 1993 to 2002, with CHD, rheumatic heart disease, hypertension, cardiomyopathy, arrhythmia and other disease, were selected. 1 500 of the patietns were as 1993/ 1995 group, the other 1 500 were as 2000/2002 group. They were in investigated the correlativity between the constituent ratio, mortality rate of CHD and the vary tendency of risk factor structure and strength about body mass, systolic pressure （SBP）, diastolic pressure （DBP）, blood sugar, total cholesterol, triacylglycerol （TG）, high density lipoprotein cholesterol （HDL-C）, smoking and so on. ②ln the Shenyang Central Hospital of Railway Station, 4 900 patients were investigated about their blood fat exception, hypertension, smoking, diabetes mellitus （DM）, body mass, anxiety state, serum cysteine, lipoprotein（a）, C-reaction protein （C-RP）, age and familial history in department of internal medicine, every department and center of body examination in 2003. It was analyzed the connection between the constituent ratio, mortality rate of CHD and the structure and strength of CHD risk factor. Absolute risk factor of cardiovascular events outbreak in railway works from Shenyang city was predicted.
RESULTS： 1 500 patients from 1993/1995 group aod 1 500 patients from 2000/2002 group were all involved in the result analysis. 4 900 patients, who were diagnosed at the Department of Internal Medicine, Central Hospital, Shenyang Railway Bureau, were all involved in the result analysis. ①The body mass, DBP and TG in the CHD risk strength ascended prominently from 1993 to 2002, The compositor of CHD risk factors were primary hypertension, body mass exceeding criterion （fat）, hypertriglyceridemia, hypercholesterolemia, smoking, DM. ② The investigated date of 2003 showed that SBP, DBP, hypertriglyceridemia, hypercholesterolemia, smoking, anxiety and age had positive correlation with the constituent ratio of CHD （r=-0.79-0.80.P 〈 0.01 ）. The SBP, DBP, anxiety and age had positive correlation with the fatality rate in the stage of hospitalization （r=0.71-0.73,P 〈 0.05）. The absolute risk of cardiovascular events in railway male workers in Shenyang city was 13.2%, while female was 9.7%.
CONCLUSION： The structure compositor of CHD risk factors in railway workers from Shenyang city is hypertension, body mass exceeding criterion, anxiety, hypertriglyceridemia, hypercholesterolemia, smoking and DM. The strength of hypertension （DBP）, hypertriglyceridenia and anxiety has ascending tendency.
出处
《中国临床康复》
CSCD
北大核心
2006年第4期9-11,共3页
Chinese Journal of Clinical Rehabilitation
