摘要
目的 调查铁路职工颈动脉粥样硬化的发生情况,并分析其相关影响因素,为动脉粥样硬化的零级预防及一级预防提供依据.方法 收集2022 年6 月至2023 年3 月某铁路公司职工2 689 例,按颈动脉超声结果分为颈动脉正常组(n=1 906,对照组)和颈动脉粥样硬化组(n=783,包括颈动脉内中膜增厚组及颈动脉斑块组).比较 2 组的性别、年龄、体重指数(body mass index,BMI)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、低密度脂蛋白胆固醇(low-density lipoproteincholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoproteincholesterol,HDL-C)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、同型半胱氨酸(homocysteine,Hcy)和脂肪肝情况是否存在差异,采用Logistic回归分析评估颈动脉粥样硬化的影响因素.结果 2 689 例体检者中检出颈动脉粥样硬化者 783 例,检出率为 29.1%,男性检出率明显高于女性(P<0.05),且随着年龄的增加,检出率升高(P<0.05).对照组和颈动脉粥样硬化组的BMI、SBP、DBP、LDL-C、TC、TG、Hcy和有无脂肪肝在不同的颈部血管彩超结果间差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,性别、年龄、SBP 和LDL-C是颈动脉粥样硬化的危险因素(P<0.05).结论 因其工作性质特点,该铁路公司职工的颈动脉粥样硬化检出率高于国内相关报道水平.性别、年龄、SBP和LDL-C是发生颈动脉粥样硬化的影响因素.应对职工进行健康宣教及健康干预,定期体检,以减少心脑血管事件的发生.
Abstract
Objective To investigate the occurrence of carotid atherosclerosis in railway workers and to analyze its influencing factors,thus providing evidence for primordial prevention and primary prevention of atherosclerosis.Methods A total of 2,689 railway workers were enrolled from June 2022 to March 2023.Based on the results of carotid ultrasound,they were divided into two groups:the normal carotid group(control group)and the carotid atherosclerosis group(including carotid intima-media thickening and carotid plaque groups).Gender,age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),total cholesterol(TC),triglycerides(TG),homocysteine(Hcy),and the presence of fatty liver were compared between the two groups.Logistic regression analysis was used to assess the influencing factors for carotid atherosclerosis.Results Among the 2,689 participants,783(29.1%)cases were detected with carotid atherosclerosis.The incidence of carotid atherosclerosis was significantly higher in males than that of females(P<0.05),which increased with aging(P<0.05).Significant differences were found between the control group and the carotid atherosclerosis group in BMI,SBP,DBP,LDL-C,TC,TG,Hcy,and the presence of fatty liver among different carotid ultrasound results(P<0.05).Multivariate logistic regression analysis revealed that gender,age,SBP,and LDL-C were risk factors for carotid atherosclerosis(P<0.05).Conclusion Due to the specific nature of their job responsibilities,the detection rate of carotid atherosclerosis in workers from this railway company is higher than that reported in domestic literatures.Gender,age,SBP,and LDL-C are influencing factors for carotid atherosclerosis.Health education and intervention should be provided to railway workers,and regular medical examinations should be conducted to reduce the occurrence of cardiovascular and cerebrovascular events.
维普
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