汇集队列风险方程与China-PAR模型在体检人群ASCVD风险预测中的应用

目的比较汇集队列风险方程(PCE)和China-PAR模型在体检人群ASCVD风险预测中的应用。方法选择2018年1月至2018年6月期间于宜宾市第一人民医院和宜宾市第二人民医行健康体检的40岁以上成年人848例,采用PCE和China-PAR评估ASCVD发病风险,探讨PCE和China-PAR在ASCVD发生风险预测中的关联性和一致性。结果PCE和China-PAR预测的10年ASCVD发病风险概率分别为(5.4±2.4)%和(4.5±2.0)%,PCE预测结果高于China-PAR(P<0.05),按年龄段、性别和居住地分层比较,PCE预测结果也高于China-PAR;不管是PCE还是China-PAR,男性ASCVD发病风险高于女性,年龄越大风险概率越高(P<0.05)。PCE预测10年ASCVD发生风险为高危者192例(22.6%),China-PAR预测10年ASCVD发生风险为低危者507例(59.8%),中危326例(38.4%),高危15例(1.8%)。Pearson相关分析显示PCE和China-PAR预测的ASCVD发生风险概率有相关性,其Pearson相关系数为0.716(P<0.05)。PCE和China-PAR预测风险等级有一定关联性,列联系数r为0.200,kappa=0.152。结论PCE可能会高估中国人ASCVD发病风险,China-PAR可能更适合中国人,但需要大样本人群队列进行进一步验证。

Application of pooled cohort risk equations and China-PAR model in ASCVD risk prediction among people with physical examination

Objective To compare the application of pooled cohort risk equations and China-PAR model in arteriosclerotic cardiovascular disease(ASCVD)risk prediction among people with physical examination.Methods From January to June 2018,848 people with physical examination were selected from 2 hospitals for stroke risk prediction by PCE and China-PAR,then the relation and consistency between PCE and China-PAR were discussed in ASCVD prediction.Results The 10 years ASCVD risk probability predicted by PCE and China-PAR were(5.4±2.4)%and(4.5±2.0)%respectively,risk probability predicted by PCE was higher than China-PAR(not only in whole,but also stratified by age,gender and residence,P<0.05).The ASCVD risk probability in male was significantly high than female predicted not only PCE but also China-PAR,the older age,the higher risk probability(P<0.05).High risk of 10 years ASCVD predicted by PCE was 22.6%(192/848),the low risk,middle risk and high risk predicted by China-PAR were 59.8%(507/848),38.4%(326/848)and 1.8%(15/848)respectively.Pearson correlation analysis showed that the ASCVD risk probability predicted by PCE was relevant to China-PAR with Pearson r 0.716(P<0.05).The risk grade predicted by PCE and China-PAR was related with contingency coefficient 0.200 and kappa 0.152.Conclusion PCE could overestimate the ASCVD risk probability among Chinese population and China-PAR may be more suitable for Chinese people for ASCVD risk prediction.However,further validation is needed in large sample population queues.