中国全科医学2017，Vol.20Issue(28)：3498-3503,6.DOI:10.3969/j.issn.1007-9572.2017.04.y04
国人评估法与汇总队列公式对健康体检人群心血管疾病风险评估价值的比较研究
Value of Chinese Evaluation Method Versus Pooled Cohort Equations for Assessing the 10-year Risk of Ischemic Cardiovascular Disease in Population Undergoing Health Examination
摘要
Abstract
Objective To determine which one of the two methods,Chinese evaluation method for 10-year risk of ischemic cardiovascular disease (hereinafter referred to as "Chinese evaluation method") proposed in 2011 Chinese Guidelinesfor Prevention of Cardiovascular Diseases and pooled cohort equations for atherosclerotic cardiovascular diseases (ASCVD) recommended by American College of Cardiology/American Heart Association (ACC/AHA) in 2013 (hereinafter referred to as " pooled cohort equations"),can evaluate cardiovascular disease (CVD) risk more accurately for population having health examination.Methods Totally 733 individuals (40-79 years old,no history of CVD) having health examination in Physical Examination Center,Beijing Chap-Yang Hospital Affiliated to Capital Medical University from April to September 2016 were enrolled.Chinese evaluation method and pooled cohort equations were used to assess their 10-year absolute risk of CVD,respectively.We chose the carotid atherosclerotic plaque as an alternative indicator of CVD.Predicting the 10-year risk of carotid atherosclerotic plaques was supposed to indirectly reflect the values of the two assessment methods for CVD risk.Results Pooled cohort equations had higher accuracy than Chinese evaluation method in predicting the absolute risk of CVD [3.6％ (6.6％) vs 1.5％ (3.4％),Z =-19.122,P ＜ 0.05].Taking 7.5％ as the value for low-risk threshold of 10-year absolute risk of CVD,participants with 10-year absolute risk value of CVD ＜ 7.5％ and ≥7.5％ could be assigned to low-risk group and non -low-risk group,respectively.The detection rate of low-risk participants of pooled cohort equations and Chinese evaluation method was respectively 73.1％ (536/733) and 94.1％ (690/733).The detection rate of non-low-risk participants of pooled cohort equations was higher than that of Chinese evaluation method [26.9％ (197/733) vs 5.9％ (43/733),x2 =146.306,P ＜ O.05].As for the prediction of the absolute risk of carotid atherosclerotic plaques,pooled cohort equations had higher area under the receiver operating characteristic (ROC) curve (AUC) value than Chinese evaluation method did ｛0.770 [95％CI (0.738,0.800)] vs0.717 [95％CI (0.683,0.749)],Z=3.935,P＜0.05}.Conclusion Pooled cohort equations assesses the 10-year risk of carotid plaques more accurately in population having physical examination than Chinese evaluation method,which suggests that it may be more accurate to evaluate the 10-year risk of CVD.Therefore,it is advisable to use pooled cohort equations clinically to identify high-risk groups timely,by which the primary prevention of CVD can be promoted.关键词
心血管疾病/危险性评估/国人评估法/汇总队列公式Key words
Cardiovascular diseases/Risk assessment/Chinese evaluation method/Pooled cohort equations分类
医药卫生引用本文复制引用
王芳,梁立荣,于丽平,钟光珍..国人评估法与汇总队列公式对健康体检人群心血管疾病风险评估价值的比较研究[J].中国全科医学,2017,20(28):3498-3503,6.基金项目
国家自然科学基金资助项目(81300148、81470541) （81300148、81470541）
