【摘要】 目的　通过对 5 137名首都钢铁公司 (首钢 )男性工人平均随访 2 0 84年 ,确认中国人群心肌梗死独立的危险因素 ,了解有关因素对发病的作用强度。方法　研究对象为 1974、1979和1980年先后进行冠心病危险因素调查的首钢 5 137名男性职工 ,平均年龄 (45 2± 7 8)岁 ,对其心肌梗死的发病情况进行了平均 2 0 84年的随访 ,分析基线调查的危险因素 (年龄、血压、血清总胆固醇含量、吸烟 )和心肌梗死发病的关系。结果　 (1)年龄是心肌梗死发病的独立危险因素 ,5 0岁后心肌梗死发病率增加。当控制血压、血清总胆固醇和吸烟状况后 ,年龄每增加 5岁 ,心肌梗死的发病危险增加 2 0 %。 (2 )随血清总胆固醇水平的增加 ,心肌梗死的发病率升高 ,血清总胆固醇≥ 4 6 8mmol/L时 ,发病率增加 ;血清总胆固醇增加 0 5 2mmol/L ,心肌梗死的发病危险增加约 4 0 %。 (3)血压是心肌梗死发病的危险因素。当控制年龄、总胆固醇含量和吸烟后 ,收缩压每增加 2 0mmHg(1mmHg =0 .133kPa)或舒张压每增加 10mmHg ,心肌梗死的发病危险增加约 4 0 %。 (4)吸烟是影响心肌梗死发病最大的危险因素。当应用多元回归分析控制了血压、胆固醇和年龄以后 ,吸烟者比不吸烟者心肌梗死的发病危险增加 137%。 (5 )Cox回归结果显示 ,血压、血更多还原

【Abstract】 Objective To identify independent risk factors for myocardial infarction (MI) in Chinese men and to develop a model to predict risk profile of an individual suffering MI.Methods Study sample included 5 137 men aged 45.2±7.8 years who came from a cohort in Beijing Capital Steel and Iron Company,based on the three surveys on coronary heart disease conducted in 1974,1979 and 1980,respectively. Demographic data and other risk factors, such as life style,medical history,blood pressure,total serum cholesterol level(TC),etc.were collected according to the same protocol in 1980. All the participants were followed up for MI in an average period of 20.84 years until 2001.Results (1) There were 122 cases with MI identified during the period of follow-up,with an incidence of MI 117.4 per 100 000 person-years. Age of more than 50,smoking,higher systolic and diastolic blood pressure(SBP and DBP) levels,higher TC all were identified as important risk factors of MI.(2)Incidence of MI increased with TC.An increment of 0.52 mmol/L of TC significantly increased relative risk of MI by approximately 40% after adjusted for age,blood pressure and smoking.(3)An increment of 20 mm Hg in SBP or 10 mm Hg in DBP associated with a 40% increase in incidence of MI,adjusting for age,TC and smoking.(4) Smoking was the most risky factors for MI.Smokers had 2.3 times risk of MI,after as compared to non-smokers(or its incidence increased by 137%),after adjusting for blood pressure,TC and age,etc. (5)Incidence of MI increased by 20% with increment of five-year of age in those aged over 50 ( P <0.05),after adjusting for blood pressure,TC and smoking.And,(6) finally,based on multivariate logistic and Cox regression analyses,a model containing several risk factors, such as age,blood pressure,TC and smoking,was developed to predict individual’s risk for afflicting MI.Conclusions Results of this prospective study showed several established risk factors for MI,including age,blood pressure,TC and smoking all as independent predictors of MI in Chinese men.It is clear and rational that intervention and modification of those traditional risk factors can lead to a decrease in coronary events in Chinese population.更多还原