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目的：慢性病预防是健康中国战略视域下的重要命题，健康普查社区无外周动脉疾病（PAD）症状老年人踝臂指数（ABI），探究其与老年人身体功能表现和精神状态等因素的相关性，实现以预防和健康为中心的战略转移。方法：招募60岁以上324名社区无PAD临床躯体症状老年人为研究对象，其中ABI正常组248名（男性64人，女性184人），ABI临界组49名（男性13人，女性36人），ABI异常组27名（男性11人，女性16人）。各组连续型数据采用单因素方差分析进行比较，分类数据采用卡方检验和似然比卡方检验进行分析。运用多元逐步logistic回归分析ABI异常的影响因素。结果：社区无PAD临床躯体症状老年人ABI异常的发生率为8.3%，临界异常的发生率15.1%；三组间单因素方差分析显示体重、BMI、腰臀比、体脂百分比、睡眠指数和双侧上肢柔韧性具有显著性差异（P <0.01）。多元逐步logistic回归分析显示，ABI临界异常与BMI(P <0.01)(OR=1.193,95%CI[1.085,1.311])和睡眠指数（P <0.05）(OR=1.088,95%CI[1.013,1.170])有相关性；ABI异常与BMI(P <0.05)(OR=1.164,95%CI[1.031,1.314])、睡眠指数（P <0.01）(OR=1.252,95%CI[1.144,1.371])和右侧上肢柔韧性（P <0.05）(OR=0.965,95%CI[0.938,0.993])有相关性。结论：BMI增高、睡眠指数增加以及机体柔韧性降低与社区无PAD临床躯体症状老年人ABI异常程度存在相关性。提示积极进行身体锻炼控制体重、改善睡眠质量和机体柔韧性可能是降低ABI异常，减低PAD发生风险的预防靶点。
Abstract：Objective:Chronic disease prevention is an important topic under the vision of Health China strategy. To census ankle brachial index(ABI)in elderly without peripheral arterial disease(PAD)clinical symptoms in the community,and explore the correlation between ABI and physical functional performance,mental state and other factors of the elderly, to achieve a strategic shift to focus on prevention and health.Methods:324 elderly people over 60 years old without PAD clinical symptoms and vitality in the community were recruited as study subjects,including 248 normal ABI group(64 males,184 females),49 borderline ABI group(13 males,36 females),and 27 abnormal ABI group(11 males,16 females). The continuous data of each group were compared by one-way ANOVA,and the classified data were analyzed by Chi square test and likelihood ratio Chi square test. Multivariate stepwise logistic regression was used to analyze the risk factors of ABI abnormality.Results:The incidence of ABI abnormality in the elderly without PAD clinical symptoms vitality in the community was 8.3%,and the incidence of borderline abnormality was 15.1%;Univariate ANOVA among the three groups showed that there were significant differences in body weight,BMI,waist hip ratio,percentage of body fat,sleep index and bilateral upper limb flexibility(P < 0.01). Multivariate stepwise logistic regression analysis showed that ABI critical abnormality was correlated with BMI(OR=1.193,95% CI [1.085,1.311]) and sleep index(P< 0.05)(OR=1.088,95% CI [1.013,1.170]);Abnormality of ABI was correlated with BMI(P< 0.05)(OR=1.164,95% CI [1.031,1.314]),sleep index(P < 0.01)(OR=1.252,95% CI [1.144,1.371]) and right upper limb flexibility(P < 0.05)(OR=0.965,95% CI [0.938,0.993]). Conclusion:The increase of BMI,poor sleep quality and poor body flexibility are the risk factors of ABI abnormalities in asymptomatic PAD elderly,suggesting that active physical exercise to control weight and obesity,improving sleep quality and body flexibility be the early prevention target of reducing ABI abnormality and risk of PAD.
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基本信息:
DOI：10.13297/j.cnki.issn1005-0000.2023.06.015
中图分类号:R543.5
引用信息:
[1]刘畅格,黄力平,曹龙军,等.健康中国战略下社区老年人外周动脉疾病相关影响因素的分析[J].天津体育学院学报,2023,38(06):717-722.DOI:10.13297/j.cnki.issn1005-0000.2023.06.015.
基金信息:
天津市教委科研计划项目（项目编号：2020SK161）
2023-12-13
2023-12-13
2023-12-13