城市社区居民高尿酸血症与脂代谢异常的关系

目的 通过社区人群筛查了解国内现阶段城市居民中高尿酸血症患病率变化,同时探讨其与脂代谢异常及胰岛素抵抗的相关性.方法 选择桂林市城区原住居民集中的象山社区,针对年龄在18～75岁之间居民(n=4 075)采取随机横断面进行筛查.结果 高尿酸血症总患病率为19.1%,男性高尿酸血症患病率为22.9%,显著高于女性高尿酸血症患病率的15.9%(P<0.001).尿酸增高还与年龄、运动时间、食用动物油、饮酒(P<0.001)及吸烟(P<0.05)有关.血尿酸水平越高,脂代谢异常越显著,并且胰岛素水平和超敏C反应蛋白水平也越高.尿酸水平与甘油三酯、胰岛素和超敏C反应蛋白水平呈正相关(P<0.01).尿酸增高的居民,血压、体重指数及腰围均较尿酸正常者高(P<0.01).结论 本研究发现我国社区居民高尿酸血症患病率已显著增高,与性别、年龄及生活习惯有关,高尿酸血症与脂代谢异常有相关性,高尿酸血症的增加与胰岛素抵抗有关,不良生活习惯可能是高尿酸血症、血脂异常以及胰岛素抵抗的共同风险因素.     

苏州地区2052例老年高血压人群血脂、血尿酸水平分析

目的探讨苏州地区老年高血压人群中血脂、血尿酸(UA)水平,为制定预防和干预措施提供科学依据。方法所有数据来源于苏州大学附属第二医院体检数据统计系统,包括总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和血尿酸(UA);采用SPSS17.0统计软件进行t检验及χ2检验处理。结果校正年龄和性别后,老年高血压人群中,男性和女性的甘油三酯(TG)及血尿酸(UA)水平明显高于正常血压水平组(P<0.05),高血压组的高甘油三酯血症(TG)和高尿酸血症(UA)的发病率明显高于正常组(P<0.05)。结论重视老年高血压人群血脂及血尿酸(UA)的检测,加强高脂血症及高尿酸血症(UA)的防治,对提高老年人的健康水平有重要意义。     

缺血性和出血性脑卒中危险因素分析

目的分析缺血性和出血性脑卒中发病的危险因素。方法回顾性分析2014年5月至2016年5月该院收治的脑卒中患者120例的临床资料,将出血性脑卒中患者设为观察组(n=60)、缺血性脑卒中患者设为对照组(n=60)。对比两组临床指标、影响因素分布,分析其发病的独立危险因素。结果观察组舒张压(SBP)、收缩压(DBP)、纤维蛋白原(FIB)、尿酸高于对照组,甘油三酯(TG)、高密度脂蛋白(HDL-C)低于对照组,差异均有统计学意义(均P0.05);观察组高血压、高血糖比例分别为85.00%、21.67%,高于对照组的61.67%、6.67%,差异均有统计学意义(均P0.05);观察组年龄60岁、脉压增大、吸烟、肥胖、高尿酸血症、高FIB血症、高TG血症、高胆固醇血症、低密度脂蛋白(LDL-C)胆固醇血症、HDL-C胆固醇血症、房颤、脑卒中史比例低于对照组,差异均有统计学意义(均P0.05);经Logistic回归分析,年龄60岁、高血压、肥胖、高尿酸、高TG、脉压增大、房颤、脑卒中史为脑卒中发病的独立危险因素(P0.05),其中与出血性脑卒中显著相关的因素为高血压,与缺血性脑卒中显著相关的因素为房颤、肥胖、高甘油三酯、脑卒中史、脉压增大、年龄60岁、高尿酸。结论出血性脑卒中与缺血性脑卒中危险因素存在一定差异,临床应根据患者具体病情采取适当预防措施,缓解疾病发作。     

高血压病合并无症状高尿酸血症临床分析

目的：探讨高血压病合并无症状高尿酸血症患者的临床特征,高尿酸血症与高血压之间的关系。方法：68例老年高血压患者为观察组,78例健康体检者为对照组,测定血浆尿酸、甘油三酯、高密度脂蛋白胆固醇,体重指数,询问生活方式。结果：416例高血压病患者中检出合并高尿酸血症68例,占16.35%。观察组的高血压病分级有2级41例和3级23例,占94.12%,血尿酸与血甘油三酯水平之间呈低度显著正相关（r为0.19,P〈0.01）;血尿酸与血高密度脂蛋白水平之间呈低度显著负相关（r为-0.209,P〈0.01）;血尿酸与体重指数之间呈中度显著正相关（r为0.254,P〈0.01）。结论：高尿酸血症是反映高血压病患者病情严重程度的一个重要指标,可作为高血压患者的常规检查项目,高血压病合并无症状高尿酸血症患者应改善生活方式。     

支持系统干预治疗对高尿酸血症合并高血压患者的影响

目的探讨支持系统对某高校教工常规体检中发现的高尿酸血症合并高血压患者的影响。方法将200例高尿酸血症合并高血压患者随机分为观察组和对照组,每组100例,观察组患者自愿接受支持系统干预治疗,对照组患者未采取任何干预措施。两组患者在干预前、干预后6个月均测量血压,空腹采血测定血尿酸、血糖、总胆固醇和甘油三酯,记录并对结果进行比较分析。结果实施支持系统干预治疗后,观察组患者血压、血尿酸、总胆固醇、甘油三酯及高尿酸血症合并高血压患病率均明显降低(P<0.05);与对照组比较,差异有统计学意义(P<0.05)。结论支持系统对高尿酸血症合并高血压患者干预效果明显,值得推广应用。     

1320名老年人血尿酸与血脂、血糖和血压的分析

目的了解老年人高尿酸血症的发病及伴随的高血脂、高血糖和高血压发生情况。方法对1320名健康体检的老年人血尿酸、胆固醇、甘油三酯、血糖和血压的测定结果与6107名中、青年健康体检者测定结果进行对比分析。结果老年组男性和女性平均血尿酸水平分别显著高于中、青年组的平均血尿酸水平(P<0.05);高尿酸血症的患病率老年组男性和女性与中、青年组差异有统计学意义(P<0.05)。老年组高尿酸血症患者高胆固醇、高甘油三酯、高血糖和高血压的检出率均明显高于尿酸正常组(P<0.05)。老年组高尿酸血症患者合并发生高血脂、高血糖和高血压的比例明显高于中、青年组(P<0.05)。结论高尿酸血症是老年人的高发病。老年人的高尿酸血症与高血脂、高血糖和高血压关系密切,应引起高度重视。     

温岭市中老年人群高尿酸血症的相关因素分析

目的了解沿海地区中老年人高尿酸血症(hyperuricemia,HUA)与年龄、血脂、血压等危险因素的相关性。方法收集在内科门诊就诊的1 236例中老年高尿酸血症患者。实验室检测其尿酸(UA)、甘油三酯(TG)、同型半胱氨酸(Hcy)、游离脂肪酸(FFA)等水平,并统计年龄、性别、身体质量指数(BMI)、血压等指标,用Logistic回归分析高尿酸血症伴心血管疾病(CVD)的危险因素,研究高尿酸血症与各因素之间的相关性。结果高尿酸血症伴CVD患者与高尿酸血症不伴CVD患者在年龄、性别、血压、吸烟、饮酒、Hcy水平上相比较,差异有统计学意义(P0.05)。Logistic回归结果显示,年龄、高血压、吸烟、饮酒、高Hcy水平等10个因素是高尿酸血症患者伴发CVD的危险因素。结论沿海地区高尿酸血症以男性中老年人为主。年龄、高血压、高血脂、高Hcy水平等均与高尿酸血症有关联。长期饮酒、吸烟是高尿酸血症伴CVD的危险因素。     

男性高尿酸血症与高血压危险度分级相关关系

[目的]探讨男性高尿酸血症与高血压危险度分级的相关关系。[方法]在来院体检的新发高尿酸血症男性中随机抽取272人作为病例组,以1:1的比例,筛选出年龄匹配的对照组,对其进行胆固醇、甘油三酯、血糖和血压等的测定,以及心血管疾病等情况的调查,参照中国高血压防治指南进行高血压危险度分级,再进行高尿酸血症与高血压危险度分级的相关关系的统计分析。[结果]高尿酸组与非高尿酸组比较,收缩压、舒张压、体重指数(BMI)、胆固醇、甘油三酯的水平差异均有统计学意义(P﹤0.05),高尿酸血症组以上各指标的均值均较高,而在吸烟、血糖这两项指标上差异无统计学意义(P﹥0.05);高尿酸血症的危险度随高血压危险度级别的增加而增加,两者之间呈正相关,其剂量反应趋势差异有统计学意义。[结论]男性高尿酸血症与高血压危险度存在剂量反应线性关系,应引起高度重视。     

重庆市区公职人员血脂水平及其相关影响因素调查

目的:了解重庆市区公职人员血脂水平及其相关影响因素. 方法:对重庆市区部分公职人员健康体检结果进行统计,并对该人群血清TC、TG与高血压病、糖尿病、高尿酸血症、冠状动脉性心脏病和脂肪肝等相关疾病的关系进行分析. 结果:高胆同醇血症、高三酰甘油血症和混合型高脂血症的患病率分别为8.8%、18.1%和9.0%;高胆固醇血症、高甘三酰油血症和混合型高脂血症人群中高血压病、糖尿病、高尿酸血症、冠状动脉性心脏病和脂肪肝的患病率非常显著的高于血脂正常组人群(P<0.05). 结论:重庆市区公职人员的高胆固醇血症、高甘油三酯血症和混合型高脂血症的患病率较高,并与高血压病、糖尿病等相关疾病有密切相关.     

老年女性高尿酸血症与高甘油三酯血症关系的研究

目的通过前瞻性队列研究探讨女性老年人群高尿酸血症与高甘油三酯血症之间的关系,为老年女性预防和保健措施提供策略。方法随机抽取相城区60岁以上甘油三酯正常老年女性994人,根据尿酸水平分为高尿酸血症组和尿酸正常组,分别跟踪调查一年后,测量其血清尿酸、甘油三酯水平等指标,应用SPSS 19.0软件进行单因素及调整年龄的Logistic回归分析。结果未调整年龄等因素时,女性高尿酸血症老年人高甘油三酯血症发病率为尿酸正常老年人的2.380倍,其95%CI为(1.463~3.872),调整年龄、总胆固醇及高密度脂蛋白等可能影响高甘油三酯发病率的因素后为2.409,95%CI为(1.433~4.051)。结论高尿酸血症老年女性高甘油三酯血症发病率明显高于尿酸正常者,应注意监测甘油三酯,同时要控制体重,改变饮食结构,参加体育锻炼,必要时服用药物。     

妊娠期高血压疾病产妇产后合并心力衰竭危险因素分析及防治对策

目的探究妊娠期高血压疾病产妇产后合并心力衰竭(以下简称心衰)的危险因素及防治对策。方法回顾性分析2016年1月至2019年11月贺州市人民医院收治的578例妊娠期高血压疾病产妇的临床资料,根据产后是否合并心衰,分为合并心衰组(64例)和未出现心衰组(514例)。对两组年龄、体质量指数、生育史、心脏病史等资料进行对比分析,将其中有统计学差异的指标进行多因素Logistic回归分析,并分析其应对策略。结果单因素分析:两组心脏病史、糖尿病史、吸烟史、贫血、熬夜、感染、情绪激动、高脂血症、高尿酸血症、肾功能不全、左心室肥厚发生情况、氨基末端脑钠肽前体(N-terminalpro-brain natriuretic peptide,NTproBNP)水平、妊娠期高血压疾病类型、高血压病史时间、血压控制情况比较,差异有统计学意义(P<0.05)。Logistic回归分析:存在心脏病史、糖尿病史、吸烟史、贫血、熬夜、感染、情绪激动、高脂血症、高尿酸血症、肾功能不全、左心室肥厚、高NT-proBNP水平、子痫前期或子痫、血压控制较差等是妊娠期高血压疾病产妇产后合并心衰的独立危险因素,差异有统计学意义(P<0.05)。结论结合妊娠期高血压疾病产妇产后合并心衰的危险因素,改善心脏负荷,避免交感神经过度兴奋,积极治疗原发病,改掉不良习惯,重点监护子痫前期孕妇,降低妊娠期高血压疾病产妇产后心衰的风险。     

Borderline fasting hypertriglyceridemia: absence of excess risk of all-cause and cardiovascular disease mortality in healthy men without hypercholesterolemia

The majority of prospective studies have shown no independent effect of triglyceride on the prediction of cardiovascular disease after the effects of cholesterol and other heart disease risk factors have been accounted for statistically. Because the association of borderline elevation of triglyceride levels (250-499 mg/dl) with cardiovascular risk might be obscured by its strong correlation with hypercholesterolemia, we examined the relationship in healthy men without hypercholesterolemia. In a population sample of 1,589 healthy fasting men ages 30-79 without known cardiovascular disease or categorical hypercholesterolemia, the prevalence of borderline hypertriglyceridemia was 4.2%, and was unrelated to age. There was no significant excess of borderline hypertriglyceridemia in men with systolic hypertension, or in men who reported use of antihypertensive drugs, current cigarette smoking, or a family history of heart attack before or after age 50. Only obesity, a personal history of diabetes, and fasting hyperglycemia were significantly more common in men with borderline hypertriglyceridemia. Moreover, hypertriglyceridemia was a relatively weak marker for those with diabetes or obesity, being present in only 9% of the former and 6% of the latter. A 12-year follow-up of these men showed no significant association of hypertriglyceridemia with all-cause or cardiovascular death either by univariate analysis or after adjusting for risk factors. These data support the conclusion that borderline hypertriglyceridemia is a poor marker for cardiovascular risk in healthy older men without hypercholesterolemia.     

影响2型糖尿病老年患者并发周围神经病变的logistic分析

目的 探讨2型糖尿病老年患者并发周围神经病变的影响因素。方法 选取2016年2月—2018年7月本院治疗的2型糖尿病老年患者120例作为研究对象,统计并发周围神经病变发生情况,根据有无发生周围神经病变分为DPN组57例和非DPN组63例,并对其影响因素进行调查分析。结果 DPN组患者与非DPN组患者的年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平差异有统计学意义(P<0.05),DPN组患者与非DPN组患者的性别、ALT、AST水平差异无统计学意义(P>0.05);Logisitic回归分析结果显示,年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平是2型糖尿病老年患者并发周围神经病变的影响因素。结论 年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平是2型糖尿病老年患者并发周围神经病变的影响因素,应积极采取有效措施进行控制糖尿病周围神经病变的发生与发展,提高2型糖尿病老年患者的生活质量。     

Risk factors in various groups of stroke patients (Analysis of 500 cases of the Budapest Stroke Database)]

Risk factor profile of 500 consecutive acute++ stroke cases in the protocol of the Budapest Stroke Data Bank has been analysed. High frequency of risk factors and additive occurrence have been documented when compared with other stroke registries; hypertension 75%, hypercholesterolemia 68%, ischemic heart disease 61%, hypertriglycerolemia 39%, smoking 38%, serious hypercholesterolemia 36%, diabetes mellitus 30%, peripheral artery disease 10%, elevated hematocrit 7% and elevated number of platelets 7%. More than one risk factors have been registered in 85% of the patients. Three risk factors at the same patient have been found in 28%. The highest number of risk factors is seven at the same patient. The stroke subtypes have been characterized with "cluster-like" association of risk factors. In the hemorrhagic group (9.4% of all cases) hypertension and alcoholism are the main factors; in the atherosclerotic group (49.4%) more male, smoking peripheral artery disease and hypercholesterolemia have been registered; in the lacunar stroke group (27%) high frequency of hypertension, smoking, diabetes mellitus, hypercholesterolemia and hypertriglycerolemia have been found and in the cardiogenic embolia group (10.6%) more female, higher age, ischemic heart disease and atrial fibrillation are the recurrent risk factors. There is no difference between the risk factor profile++ registered in the left versus right hemispheral strokes, in the anterior versus posterior strokes and in the first ever or recurrent strokes.     

Epidemiology of cardiovascular disease risk factors in Catalonia (Spain)

Cardiovascular disease is one of the most important public health problems in developed countries. We have studied the epidemiology of the following cardiovascular disease risk factors in a random sample (n = 704) of the adult population of Catalonia (Spain): hypercholesterolemia ( 6.1 mmol/1 or 240 mg/dl), hypertension (SBP 160 and/or DBP 95 mmHg), low HDL-cholesterol concentrations (< 0.9 mmol/l or 35 mg/C), hypertriglyceridemia (> 2.8 mmol/1 or 250 mg/dl), obesity (BMI > 30), smoking and history of diabetes and coronary heart disease.Two percent of participants had hypertriglyceridemia, 3% had a history of coronary heart disease, 4% a history of diabetes, 6% low HDL-cholesterol concentrations, 12% were obese, 20% had hypertension, 24% had hypercholesterolemia and 36% were smokers. 58% of hypertensive individuals had been previously detected, 46% were currently on treatment, and 21% had their blood pressure controlled (SBP < 160 and DBP < 95 mmHg).Correlation and multiple regression analyses were used to investigate the association between cardiovascular risk factors. Multiple linear regression analysis showed independent correlations between risk factors. Prevalence of hypercholesterolemia, obesity and diabetes was higher and prevalence of smoking was lower in hypertensives than normotensives. The odds ratio was 3.68 (95% CI = 2.07–6.54) for hypercholesterolemia, 3.26 (95% CI = 1.52–7.02) for obesity, 3.81 (95% CI = 1.09–7.02) for diabetes and 0.40 (95% CI = 0.22–0.70) for smoking. The adjusted odds ratio was statistically significant for hypercholesterolemia (OR = 2.74, 95% CI = 1.01–3.75).The prevalence of cardiovascular risk factors was similar to that observed in other Mediterranean communities. The association between cardiovascular risk factors shows that there are biological interrelations between risk factors that influence the development of arteriosclerosis.     

老年高血压患者危险因素分析及干预对策

目的 探讨影响老年高血压患者的危险因素以及干预的对策.方法 共纳入85例老年高血压患者,同时从门诊随机抽取140例无高血压病史的老年人群作为对照组.详细记录所以受试者的基本信息、高血压患病情况及相关影响因素.应用非条件Logistic回归分析进行多因素分析.结果 单因素分析结果表明:两组间男性、冠心病病史、糖尿病史、吸烟史、入院首次SBP、家族高血压病史、饮酒史、LDL-C及HDL-C比较差异有统计学意义;其中冠心病病史、糖尿病史、吸烟史、入院首次SBP、家族高血压病史、饮酒史、LDL与老年高血压发生呈正相关;HDL-C与老年高血压的发生呈负相关(P＜0.05).进一步行多因素分析结果表明:糖尿病史、吸烟史、高血压家族史是老年高血压病患者发生的独立危险因素;而HDL-C是老年高血压病患者发生的保护因素.结论 糖尿病史、吸烟史、高血压家族史是老年高血压病患者发生的独立危险因素;而HDL-C是老年高血压病患者发生的保护因素,应该大力提倡全民健身,同时戒烟限酒,对有上述危险因素的老年人群进行必要的干预,可明显降低高血压的发生率.     

Risk factors in arteriosclerosis and cardiovascular disease with special emphasis on cigarette smoking.

Large international differences in mortality from the atherothrombotic diseases, notably coronary heart disease, suggest that differences in environment and lifestyle may be important. Cholesterol is the lipid characteristically found in the atheromatous plaque. Serum cholesterol concentration is invariably higher in populations with high rates of coronary heart disease than in populations where the prevalence is low. The serum cholesterol level is probably determined by the amount of fat habitually consumed and only infrequently by genetic factors. Arterial hypertension and heavy cigarette smoking powerfully increase the risk of coronary heart disease in the presence of hypercholesterolemia. The mechanism whereby cigarette smoking aggravates and accelerates atheropoiesis is unknown, but carbon monoxide and mobilization of catecholamines are probably implicated. The prevalence of the atherothrombotic diseases and of their ischemic complications can, in theory, be reduced by controlling hypercholesterolemia and hypertension and eliminating cigarette smoking.     

392例青年脑卒中的病因及危险因素分析

目的 探讨青年脑卒中的病因及危险因素.方法 回顾性分析连续住院的392例青年脑卒中患者(年龄≤45岁)的临床资料,分析其病因及危险因素.结果 青年缺血性脑卒中最常见的病因是动脉粥样硬化(48.70%,112/230),其次是心源性脑栓塞(13.04%,30/230).青年出血性脑卒中主要的病因是高血压(39.51%,64/162),其次是颅内动脉瘤(14.81%,24/162)和脑血管畸形(10.49%,17/162).青年脑卒中的危险因素是高血压(40.31%,158/392)、吸烟(36.22%,142/392)、饮酒(33.93%,133/392)、脑卒中史(13.78%,54/392)、高脂血症(11.99%,47/392),其他有心脏病(9.69%,38/392)、脑卒中家族史(8.16%,32/392)、糖尿病(5.36%,21/392)等.对160例及110例患者分别进行同型半胱氨酸和抗心磷脂抗体测定,阳性率分别为39.38%(63/160)和3.64%(4/110).结论 青年缺血性脑卒中最常见的病因是动脉粥样硬化,其次是心源性脑栓塞;青年出血性脑卒中最常见的病因是高血压,其次是颅内动脉瘤、脑血管畸形.青年脑卒中的危险因素有高血压、吸烟、饮酒、脑卒中史、高脂血症,其他有心脏病、脑卒中家族史、糖尿病、高同型半胱氨酸血症等.     

Coronary heart disease risk factors in urban bus drivers

The purpose of this study was to determine the risk factors for coronary heart disease (CHD) in 2297 bus drivers and skilled workers from the Taipei Municipal Bus Administrative Bureau. Data for this study were compiled from the medical records of annual physical examinations for bus drivers and skilled workers conducted at Taipei Municipal Chronic Disease Hospital during the period from July 1998 to June 1999. The results showed that, after adjustment for age, hypertension rates for bus drivers (56.0%, 986/1361) were significantly greater than for skilled workers (30.6%, 164/536). All age groups demonstrated a similar difference. Significant differences were also noted in body mass index, serum cholesterol, serum triglyceride and ischemic heart disease between bus drivers and skilled workers. Among bus drivers, the prevalence of obesity was 9.6%, hypercholesterolemia 34.0%, hypertriglyceridemia 69.4% and ischemic heart disease 1.7%. By contrast, among skilled workers, the prevalence of obesity was only 4.6%, hypercholesterolemia 29.9%, hypertriglyceridemia 30.6% and ischemic heart disease 0.9%. These findings suggest that exposure to the occupation of driving a bus may carry an increased risk of CHD and that drivers who develop signs of cardiovascular illness should be transferred to non-driving occupations within the company.