高血压病患者致心脑血管并发症的危险因素的量化价
基本信息
作者: 傅华 王家良 符宗胤 章茂顺
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研究方向： 
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指导老师: 
写作日期: 
字数: 5,889
编号: 47
类别: 医学〉临床医学
级别: 学术论文

【摘要】 
目的 建立并评价高血压病心脑血管并发症有关的危险因素的定量计分系统。
方法 1)应用Delphi（德尔菲）专家调查法,建立“高血压病致心脑血管并发症危险因素评分系统(QSRFCCVD)”；2)借助病例－对照研究和ROC曲线（Receiver Operator Charact-eristic Curve）分析方法，验证和评价该评分系统判断或预测心脑血管疾病的临床意义和应用价值；3)统计分析采用STATA3.0软件。
结果 1)经多元分析表明年龄、未接受降压治疗、舒张压水平和LDL/HDL比值等因素与高血压病心脑靶器官损害的危险性有显著的意义；2)在病例组21个危险因素的平均积分为57.34±11.86而对照组为33.89±14.47，两者差异性十分显著；3)ROC曲线分析显示 QSRFCCVD的最佳阈分值点为44分，对心脑血管疾病的预测敏感性和特异性分别为90％和80％。ROC曲线下面积（AUCROC）为0.9±0.07。
结论 该评分系统对高血压病致心脑靶器官损伤的预测和判断以及有针对性地综合干预危险因素，具有颇佳的临床意义与实用性。
【关键词】高血压病 心脑血管并发症 危险因素 德尔菲(Delphi)专家调查法 
A Quantitative Study Of Risk Factors Associated With Hypertensive Cardiocerebrovascular Disease Fu Hua, Wang Jialiang, Fu Zhongyin, et al. Department of Clinical Epidemiology and Internal Medicine, First University Hospita, West China University of Medical Sciences, Chengdu 610041
[Abstract] Objective To assess a quantitative score system of risk factors (RF) associated with hypertensive coronary-cerebro-vascular diseases(CCVD) including coronary heart disease, myocardioinfarction, hypertensive heart disease and stroke, and to be used to prevent CCVD in antihypertensive practice in the Community. Method 1) To invite 32 famous cardiologists in China assessing score for RFs associated with CCVD by Delphi’s method and to establish a quantitative score system of RF for CCVD (QSRFCCVD) in HT. 2) A case-control study was conducted to assess the validity for the QSRFCCVD, in which 58 hypertensives with CCVD as cases and 164 cases without CCVD as controls. 3) ROC method was used to detect the best cut off point for diagnosing CCVDs for the QSRFCCVD. 4) STATA 3.0 was used to analyze these data. Results 1) CCVD was positively significant associated with the following factors: age, DBP, no treatment for HT and LDL/HDL ratio by Logistic Analysis; 2) The mean score of 21 RFs was 57.34± 11.86 in case and 33.89± 14.47 in the control group using the QSRFCCVD system, there was a significant different between these two groups; 3) By ROC analysis, 44 score was the best cut off point for QSRFCCVD; the sensitivity was 90%, the specificity was 80% and AUCROC=0.9± 0.07 for predicting CCVD by the QSRFCCVD. Conclusion Up to now, there is not a quantitative score of RF of CCVD in China. This QSRFCCVD might be useful significantly for detecting and diagnosing CCVD and for treating HT in the hypertensive practice in the Community.
[Key Words] hypertension cardiovascular complication risk factor Delphi’s