原发痛风的临床特点及高危因素分析

 目的对原发痛风的临床特点及高危因素进行分析.方法病例选自2002年1月～2004年12月在痛风门诊就诊的165例新患者,资料处理采用条件Logistic回归分析.结果发病年龄范围24～72岁,男163例,女2例.首发部位以第1跖趾关节最常见138例(86.3%).原发痛风的独立危险因素:高血压及家族史、冠心病及家族史、目前收缩压和舒张压、BMI、尿酸排泄分数、急性痛风关节炎发作部位的外伤史、痛风家族史、TG、TC、LDL、VLDL的升高及HDL2-C的降低.结论国人对于原发痛风的危险因素应早期预防.     

原发性痛风临床特点及危险因素分析

 目的 了解原发性痛风的临床特点,分析与其相关的高危因素,为临床诊断以及预防痛风提供参考.方法 回顾性分析195例初诊的原发性痛风患者的一般情况、生活方式、临床资料,以及实验室检查结果,并对原发性痛风发生的危险因素进行分析.结果 195例中,男性占97.4％ (190/195),发病高峰在40～60岁(54.9％,107/195).最常见的首发部位为第一跖趾关节,占86.2％ (168/195).单因素Logistic同归分析显示:(1)原发性痛风的发生与高嘌呤饮食相关,与吸烟、饮酒无关,若患者生活中既饮酒又吸烟,痛风发生的危险性将明显增高;(2)高体质指数(body mass index,BMI)、高血压、高血压家族史、冠心病家族史为原发性痛风的高危因素;(3)血脂组中:除载脂蛋白A(Apo -A)外,其余指标均与原发性痛风相关.三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(Apo -B)浓度的升高,高密度脂蛋白胆固醇(HDL - C)浓度的降低为痛风发病的高危因素.血清尿酸清除分数( FEuA)降低是痛风发生的独立危险因素.结论 中老年男性原发性痛风的发病率较高,原发性痛风的危险因素包括:高嘌呤饮食,饮酒合并吸烟,高BMI、高血压、高血压家族史、冠心病家族史,高血脂等.中国人存在多种原发痛风的危险因素,应早期预防.     

原发痛风的家系一级亲属血清胰岛素水平及β细胞功能的研究

 目的 研究原发痛风的家系一级亲属血清胰岛素水平及β细胞功能.方法 23个原发痛风患者的核心家庭成员42人,正常人41例口服葡萄糖耐量试验(OGTT)后2 h血糖(2 Hpg)、胰岛素(2 hIns)及胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、血尿酸(UA)的测定.空腹、餐后2 h血糖、胰岛素并计算胰岛素抵抗指数(HOMA-IR),进行对照分析.结果 原发痛风一级亲属组血尿酸、胆固醇、三酰甘油水平明显高有于对照组;胰岛素、胰岛素抵抗指数明显高于对照组,且差别有统计学意义.结论 原发痛风患者一级亲属中存在高胰岛素血症.     

原发痛风对血脂、纤溶活性和凝血的影响

 目的 探讨原发痛风对血脂、凝血和纤溶活性的影响。方法1996年1月～2000年12月原发痛风患者133人,与健康者(正常对照)135人做病例对照研究,比较血脂、凝血和纤溶活性指标的变化,血脂引入条件Logistic回归分析。结果病例与对照两组均数比较,TG、LDL、VLDL、apo-B、Lp(a)病例组明显高于对照(P＜0.01);HDL-C、HDL2-C病例组低于对照组。病例与对照两组均数比较,结果显示：TG、LDL、VLDL、apo-B、Lp(a)病例组明显高于对照(P＜0.01);HDL-C、LDL 2-C病例组低于对照组,TG、TC、LDL、VLDL的升高及HDL 3-C的降低与痛风危险存在统计学相关。tPA明显低于对照;PAI病例组明显高于对照组。结论 原发痛风患者早期需防治动脉粥样硬化。     

妊娠期糖尿病合并妊娠期高血压综合征初产妇不良妊娠结局风险预测模型构建

目的 探讨妊娠期糖尿病(GDM)合并妊娠期高血压综合征(PIH)初产妇不良妊娠结局的危险因素,并构建风险预测模型。方法 选取2019年1月—2023年5月收治的GDM合并PIH初产妇120例,根据妊娠结局将其分为不良组(57例)和良好组(63例)。采用多因素Logistic回归分析筛选影响此类患者不良妊娠结局的危险因素,据此构建列线图模型并进行验证和效能评估。结果 不良组中高龄产妇所占比例、孕前体质量指数(BMI)、孕期体质量增加、有糖尿病家族史所占比例、PIH类型、糖化血红蛋白(HbA1c)、总胆固醇高于良好组,高密度脂蛋白胆固醇低于良好组(P<0.01,P<0.05)。多因素Logistic回归分析结果显示,高龄产妇、孕前BMI、糖尿病家族史、子痫前期/慢性高血压并发子痫前期、子痫、HbA1c为GDM合并PIH初产妇不良妊娠结局的独立危险因素(P<0.01)。根据多因素Logistic回归分析结果建立GDM合并PIH初产妇不良妊娠结局预测模型方程并构建列线图模型,受试者工作特征曲线显示曲线下面积为0.821, Bootstrap内部验证显示区分度良好,校准曲线显示...     

航海人员单纯收缩期高血压影响因素分析

目的　了解航海人员单纯收缩期高血压 (ISH)的患病率及相关危险因素。方法　对 1997年上海地区海域航海人员资料整理并行 logistic回归分析。结果　 ISH患病率为 2 .5 %。危险因素为体重指数 (BMI)。年龄或工作年限有保护作用。末次测压的 ISH值与父系高血压家族史相关。结论　本组(ISH)高血压机制及危险因素普通高血压病均有所不同 ;即使在 BMI<2 5也增加 ISH危险。     

糖尿病等病史、家族史与胰腺癌关系的研究

探讨中国人胰腺,癌的发生与糖尿病等疾病及家族史的关系。以493例病理确诊的胰腺癌患者作为病例组，1031例非肿瘤患者年龄和性别、经济收入频数匹配的同来源病例为对照组，用病例对照研究的方法比值比（OR）及95％可信区间（CI），以估计糖尿病等病史及家族史的相对危险性。结果表明，诊断胰腺癌2年以上患糖尿病、胆石症、慢性胰腺炎、癌症、肺结核病、丝门螺杆菌感染、癌症家族史和糖尿病家族史的OR值（95％CI）分别为4.64(2.05-10.49）、4.12(2.81-6.04)、18.38(6.33-53.35)、9.47(4.97-18.06）、4.21(2.30-7.72）、1.14(0.45-2.89）、2.01(1.29-3.14)、0.83(0.15-4.56）。糖尿病和胆石症Logistic回归分析P＜0.05。因此糖尿病、胆石症、胰腺炎、癌症史、肺结核病史及癌症家族史是胰腺癌的危险因素，而糖尿病和胆石症是其独立危险因素。     

缺血性脑卒中发病因素的病例对照分析

目的探讨缺血性脑卒中的相关危险因素,为采取有效的防治措施提供科学依据。方法选择我院新发的缺血性脑卒中患者120例为病例组,1∶1匹配年龄相差≤3岁、同性别和同民族的非心脑血管病患者120例作为对照组。单因素和多因素条件Logistic回归筛选危险因素。结果 (1)单因素分析显示高血压史、心脏病史、糖尿病史、病前血压波动、高胆固醇血症、高血压家族史、吸烟、饮酒、爱吃咸食、低密度脂蛋白升高、高血尿酸、性格急躁、经常性紧张均为缺血性脑卒中的危险因素,体育锻炼是保护因素。(2)高血压病(OR=3.544,95%;CI:1.923～6.530)、吸烟(OR=3.219,95%;CI:1.760～5.889)、心脏病史(OR=2.409,95%;CI:1.382～4.197)、糖尿病(OR=1.914,95%;CI:1.106～3.311)入选多因素条件Logistic回归方程。结论高血压病史、吸烟、心脏病史、糖尿病是缺血性脑卒中发生的独立危险因素,预防脑卒中的关键在于控制和干预这些危险因素。     

原发痛风代谢指标的遗传研究

 目的原发痛风患者的代谢指标的家系遗传.方法20个原发痛风患者的核心家庭成员78人,对资料进行条件Logistic回归分析并计算遗传.结果成员中新发现痛风4人,高尿酸血症5人.血清尿酸水平父-子、中亲-子之间明显相关;尿酸清除分数父-子、母-女、中亲-女中亲-子女存在相关关系,其-级亲属的遗传度为(77.20±10.11)%,.血脂的家系成员的遗传度在(6.00±1.89)%～(58.60±9.01)%.结论原发痛风患者一级亲属应早期预防痛风.     

高血压和冠心病120例血脂及载脂蛋白检测分析

高血压是我国最常见的心血管疾病,它不仅患病率高,也是CHD的主要危险因素.血清胆固醇(TC)、甘油三酯(TC)、低密度脂蛋白胆固醇(LDL)增高,高密度脂蛋白胆固醇(HDL)降低是CHD发病的危险因素之一.     

The prevalence of cardiovascular disease risk factors of Hong Kong Chinese.

BACKGROUND: In Hong Kong, the prevalence of cardiovascular heart disease (CHD) increased from 38.6% in 1972 to 59.4% in 1992 and has become an area of concern. The present study intended to identify the CHD risk factors of 18-60 year old Hong Kong Chinese and recommend primary prevention programmes accordingly. METHODS: Subjects (N=1432) were systemically recruited from community and sports centres in urban and rural districts in order to balance the effects of age, gender and economic status. Eight major CHD factors were identified and criteria used for classifying them as high risk were as follows: high blood pressure (SBP: over 160 mmHg or DBP: over 95 mmHg); total blood cholesterol (over 6.2 mmol/L) or high density lipoprotein (HDL) under 0.9 mmol/L; cigarette smoking; overweight (BMI over 27.5, or percent body fat over 25 for men and 30 for women); exercise habit (no exercise or exercise less than once per week); alcohol consumption (over 6 drinks or 90 ml ethanol per week); diabetes mellitus; and family history (one or both parents died of CHD before the age of 60 years). All testings and data collection were conducted at the laboratory in 1997-98. Differences in the prevalence of CHD risk factors due to age and gender were then investigated. RESULTS: It was found that the percentages of subjects with high risk factors were substantially lower than those reported in other countries e.g., Australia and the People's Republic of China. The prevalence of CHD risk factors increased with age and it was also higher in the male subjects. There were more men with three or more CHD risk factors than women (23.5 vs 9.9%). CONCLUSIONS: It was suggested that the Hong Kong SAR Government should launch primary prevention programmes to eliminate the five behaviour-related CHD risk factors identified in the present study and monitor their prevalence in the future.     

The effects of exercise on coronary heart disease risk factors in children

Coronary heart disease (CHD) is now recognised as a paediatric problem despite the fact that clinical symptoms of this disease do not become apparent until much later in life. Epidemiological studies of risk factors in children have now been conducted. These studies suggest that the risk factors for cardiovascular disease in adults, which include a family history of heart disease, elevated blood lipids (serum cholesterol and triglycerides), obesity, hypertension, smoking, diabetes mellitus and inadequate physical activity, can be identified in children. Several investigators have reported the existence of one or more risk factors in more than 50% of the children they have examined. It is now clear that we can detect most children who are potentially at risk for CHD. The notion of 'tracking' some of the most common CHD risk factors in children has been used in several studies. Results from this type of research indicate that children who are at the extreme end of the distribution and have high levels of blood pressure, adverse lipid levels and are obese will continue to exhibit these coronary risk factors as they grow. The research completed at present does not answer the question of whether children who exhibit a coronary-prone risk factor profile will exhibit this same profile at an age when one is most likely to develop the clinical manifestations of CHD. It does make sense, however, to identify those children who may be at risk for developing premature CHD and to initiate safe interventions such as behaviour modification, changes in diet and increases in physical activity. These have all been shown to alter risk factors which are associated with increased relative risk of CHD in adults. It should be noted that in adults regular aerobic exercise often may alter all risk factors for CHD, including hypertension and diabetes. Whether regular aerobic exercise will induce similar changes in children is not fully understood.     

Age and other predictors of coronary heart disease

Multiple factors contributing to coronary heart disease (CHD) and underlying atherosclerosis have been identified. Biologic factors include aging, gender, and family history. Potentially modifiable risk factors are: cigarette smoking; high blood pressure; elevated levels of plasma total and low density lipoprotein and low levels of high density lipoprotein cholesterol; diabetes mellitus; obesity; dietary habits; physical inactivity and poor physical fitness; and perhaps response to psycho-social stress. CHD risk increases with the number of risk factors and their levels. Resting and exercise ECG abnormalities further increase risk. Because of differences in levels of these risk factors, a great deal of variability exists in probability of CHD at any age. Using age alone to predict risk of heart attack results in high rates of false positives. Favorable alterations in modifiable risk factors by the American public appears to be primarily responsible for the progressive decline in CHD mortality rates in this country since 1968. This decline has occurred at all ages during a period of dramatic increase in prevalence of people over 65 yr of age in the United States. This confirms that modifiable risk factors are much more important than age in the etiology of CHD, and clearly demonstrates that CHD is not an inevitable part of the aging process.     

Exercise for the Older Adult

In brief: Sixty-three students aged 7 to 12 years (32 boys, 31 girls) were assessed for coronary heart disease (CHD) risk factors, including family history of CHD, blood pressure, VO₂ max, serum lipids, body composition, and history of diabetes mellitus and cigarette smoking. Forty-two percent of the children had one risk factor, and 12% and 3% had two and three risk factors, respectively. This information was used to encourage school administrators and faculty to modify the physical education program, teach health and fitness concepts in the classroom, and develop a rehabilitation program for children at risk.     

某高校退休职工骨质疏松现状调查及影响因素分析

 目的 了解某高校退休职工骨质疏松症(osteoporosis,OP)现状,分析骨质疏松相关影响因素。方法 选取2016年1－6月于北京交通大学社区卫生服务中心参加常规体检的785名该校离退休教职工,采用双能X线骨密度仪( DXA)测腰椎(L_1-4)、股骨颈、Ward三角区、大转子区的骨密度,并进行标准的问卷调查及实验室常规检测,根据骨密度分为骨质疏松组和非骨质疏松组,单因素方差分析比较两组一般资料,利用多因素Logistic回归分析骨质疏松的影响因素。结果 OP患病率为23.06%。单因素分析结果显示,两组在性别、年龄、压力、文化程度、吸烟、饮酒、饮牛奶、收缩压、舒张压、体重指数(BMI)、腰臀比(WHR)、三酰甘油(TG)、总胆固醇(TC)、 低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖尿病、冠心病、脑卒中、高血压病史方面均有统计学差异(P<0.05)。多因素Logistic回归分析发现,女性、增龄、大WHR、吸烟、合并高血压、糖尿病、脑卒中、冠心病为OP可能危险因素,高文化程度、高BMI为OP保护因素。结论 退休教职工OP状况严峻,患病率较高,年龄增大、女性、向心性肥胖、吸烟、合并高血压、糖尿病、脑卒中、冠心病的人群更容易发生OP。     

高血压对男性冠心病患者血脂和载脂蛋白的影响

 目的观察高血压对男性冠心病患者血脂和载脂蛋白的影响.方法将276例患者分为高血压病组(EH,83例)、冠心病组(CHD,85例)、高血压合并冠心病组(EH+CHD,108例).选择健康体检者106例作为对照组.比较三组患者的血脂和载脂蛋白的变化情况,并做分层分析.结果(1)三组患者的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(Apo B)水平均明显高于对照组,而高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A-I(Apo AI)和Apo AI/B的水平明显降低(P＜0.05).(2)未按年龄分组时,各项血脂水平在三组患者中差异无统计学意义.(3)按年龄分层后,≤55岁组中EH+CHD组TC、甘油三酯(TG)和LDL-C的水平最高.结论高血压患者存在血脂代谢紊乱,在合并冠心病时高血压对血脂具有叠加作用,应加强中青年男性高血压患者的调脂治疗.     

上海地区海域船舶人员高血压危险因素分析

目的　了解船舶人员高血压发病情况及危险因素 ,以指导防治。方法　对 1997年高血压普查资料行初步整理 ,并着重对高血压危险因素行 logistic回归分析。结果　高血压患病率为 6 .3%。危险因素有年龄、超体重、父系家族史、海上工作年限、职别及行政管理工作。结论　本调查确定的高血压危险因素与全国抽查结果相符 ;父系家族史对男性子代有遗传优势 ;可通过体育锻炼减少高血压发病。     

中老年人业余体育活动、体质与冠心病危险因素

目的 :探讨业余体育活动水平 (LPAL)、体质 (PF)与冠心病 (CHD)危险因素的关系。方法 :用多因素分析方法观察了LPAL、PF、有规律的体育活动年限 (RPA)对 179名 5 0～ 70岁受试者血压 (BP)、血清甘油三酯 (TG)、总胆固醇(TC)、高密度脂蛋白胆固醇 (HDL -C)的影响 ,并调整了年龄、性别及其它生活方式参数。结果 :较少的体育活动、较差的体质水平有较高的BP、TG、TC和较低的HDL -C、HDL -C/TC ;调整混淆因素后RPA与CHD危险因素无独立相关 ,TG、TC、HDL -C、HDL -C/TC与PF独立相关 ,BP与LPAL独立负相关。提示PF比LPAL对血脂和脂蛋白有更大的影响 ,而LPAL比PF对BP有更大的影响。     

军队离退休干部脑卒中患者危险因素调查

目的了解军队离退休老干部脑卒中幸存者的危险因素暴露情况。方法对门诊和住院的477例脑卒中幸存者,进行危险因素调查。将研究对象以年龄分组,分析并描述脑卒中危险因素的暴露水平、血压水平及其年龄分布。结果脑卒中幸存者的原发性高血压史、心脏病、糖尿病、脑卒中家族史、原发性高血压家族史、肥胖、吸烟、饮酒的暴露率分别为62.9%、31.9%、13.0%、25.2%、31.7%、20.5%、41.9%和29.1%。各年龄组间体质指数(BM I)和舒张压水平有显著差异,随年龄增长而下降。收缩压水平≥140 mmHg者占71.9%,舒张压水平≥90 mmHg者占61%,各年龄组间舒张压水平的分布差异有统计学意义。结论军队离退休老干部脑卒中幸存者危险因素暴露处于较高水平,原发性高血压的控制率有待提高。