中老年男性冠心病危险因素的分布及演变

目的 探讨冠状动脉粥样硬化性心脏病(CHD)危险因素在中老年男性人群中的分布及其演变,为不同年龄男性人群CHD的防治提供依据. 方法 集中对我院部分在职干部和所属134个军队社区及离退休干部2176人进行体检,选择资料完整,年龄45以上的男性受检者1639人,将其分为非老年组(45～59岁)及老年组(60～93岁)进行CHD危险因素分析;再将60岁以上受检者分为3组(60～69岁、70～79岁、80～93岁),对老年人随增龄CHD危险因素的演变进行逐项分析.结果 非老年组饮酒、吸烟、舒张期高血压、低高密度脂蛋白胆固醇(HDL-C)的检出率分别为48.0%、24.6%、22.7%、8.3%,高于老年组31.6%、14.1%、13.2%、3.2%(x2分别为28.80、18.35、15.72和17.84,均为P<0.01);老年组超体质量、收缩期高血压、高空腹血糖、高餐后2 h血糖(2 hPBG)的检出率分别为45.5%、33.2%、15.2%、40.5%,高于非老年组25.4%、11.1%、8.1%2、6.2%(x2分别为36.40、50.97、9.09和18.98,均为P<0.01);两组高三酰甘油(TG)、高胆固醇的检出率分别为36.9%、31.5%及18.0%、16.2%,组间比较差异无统计学意义(均为P>0.05).70～79岁组超体质量及高2 h PBG的检出率降低(P<0.05);饮酒、吸烟、舒张期高血压、高TG的检出率减少,差异均有统计学意义(均为P<0.01);80～93岁组超体质量、高2 h PBG及高TG的检出率与70岁以上老年组比较降低(x2分别为10.05、4.16、5.97,均为P<0.01);收缩期高血压的检出率70岁及以上老年组明显高于60～69岁组,差异均有统计学意义(X2=21.25,P<0.01);其他CHD危险因素老年各年龄组间比较,差异无统计学意义(P>0.05). 结论 非老年人CHD危险因素干预的重点为戒烟、限酒、低脂饮食、改变不良牛活习惯,控制舒张期高血压及有效的调脂治疗;老年人CHD危险因素干预重点则为限制总热量摄入、适量运动、减轻体质量、控制收缩期高血压、高血糖及进行有效调脂.

Distribution and evolution of the risk factors for coronary heart disease in middle-aging males

Objective To analyze the distribution and evolution of the risk factors for coronary heart disease (CHD) in middle-aging males, and provide the evidence for the prevention and treatment of male patients with CHD. Methods 1639 male people over 45 years old were enrolled in the study. They were divided into non- senile group (45-59 years old) and senile group (60-93 years old).The subjects over 60 years old were further divided into three groups:60-69 years old group, 70-79 years old group, 80-93 years old group. The interrelation between the risk factors of CHD and aging was analyzed. Results The prevalence rates of drinking, smoking, diastolic hypertension and low HDL-C in non-senile group were much higher than those in senile group (x2=28.80,18.35,15.72,17.84,P<0.01). In contrast, the prevalence rates of overweight, systolic hypertension, fasting hyperglycemia,postprandial hyperglycemia in senile group were significantly higher than those in non senile group. The prevalence rates of high triglyceride in non- senile group and senile group were 18.0% and 16.2% respectively(P>0.05). The prevalence rates of high cholesterol in non- senile group and senile group were 36.9% and 31.5% respectively(P>0.05). There was a significant decrease in the prevalence rates of overweight, postprandial hyperglycemia (P<0.05) and drinking,smoking, diastolic hypertension, high triglyeeride (P<0.01) in over 70-year+old males. And the prevalence rates of overweight, postprandial hyperglycemia, high triglyceride of over 80-year-old males were higher than those of over 70-year-old males (x2=10.05,4.16,5.97,P＜0.01). However,the prevalence rates of systolic hypertension of over 80-year-old males were lower than those of over 70-year-old males (X2=21.25,P＜0.01). There was no significant change in other risk factors of CHD at different ages of senile group. Conclusions For non-senile males, the important measures to treat the risk factors of CHD should include stopping smoking, restricting alcohol, eating low fat diet, changing bad life habits, controlling diastolic hypertension and modifying lipid. In contrast, for senile males, more attention should he paid to limiting total energy intake, increasing sports, losing weight, controlling systolic hypertension, hyperglycemia and modifying lipid.