
Chinese General Practice ›› 2025, Vol. 28 ›› Issue (29): 3645-3652.DOI: 10.12114/j.issn.1007-9572.2025.0087
Special Issue: 心力衰竭最新文章合辑
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Received:2025-02-06
Revised:2025-05-20
Published:2025-10-15
Online:2025-08-26
Contact:
HAN Quanle
通讯作者:
韩全乐
作者简介:作者贡献:
邓洁提出研究思路,设计研究方案,撰写论文;齐祺负责研究过程的实施,检验数据的收集和分析、绘制图表;吴欣雨负责文献/资料收集、整理;李雷、蒋越、郁静、吴若洁、吴寿岭、李康博为研究方案提供意见和指导;韩全乐对文章的知识性内容进行批评性审阅,质量控制及审校,负责最终版本修订,对论文负责。
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| 组别 | 例数 | AIP | 年龄(岁) | BMI (kg/m2) | WC (cm) | SBP (mmHg) | DBP (mmHg) | MAP (mmHg) | FBG (mmol/L) | TG [M(P25,P75),mmol/L] |
|---|---|---|---|---|---|---|---|---|---|---|
| Q1组 | 24 937 | -0.90±0.28 | 51.7±13.4 | 23.5±3.2 | 83.11±9.95 | 127±21 | 81±11 | 96±14 | 5.19±1.36 | 0.72(0.58,0.87) |
| Q2组 | 24 940 | -0.35±0.11 | 51.8±12.9 | 24.7±3.3 | 85.92±9.55 | 130±21 | 83±11 | 99±14 | 5.37±1.47 | 1.10(0.94,1.25) |
| Q3组 | 24 938 | 0.06±0.13 | 52.4±12.5 | 25.6±3.4 | 88.46±9.61 | 132±21 | 84±12 | 100±14 | 5.55±1.70 | 1.51(1.29,1.78) |
| Q4组 | 24 940 | 0.80±0.42 | 51.6±11.8 | 26.4±3.4 | 90.75±9.33 | 135±21 | 86±12 | 102±14 | 5.81±2.06 | 2.74(2.12,3.90) |
| 检验统计量值 | 86.68 | 1 981.21 | 219.42 | 532.90 | 979.11 | 260.10 | 652.22 | 128.82 | 119.10a | |
| P值 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | |
| 组别 | TC (mmol/L) | HDL-C (mmol/L) | LDL-C (mmol/L) | hs-CRP [M(P25,P75),mg/L] | HR (次/min) | eGFR [mL·(min)-1·(1.73 m2)-1] | 性别(男/女) | 高中及以上受教育程度[例(%)] | ||
| Q1组 | 4.84±0.97 | 1.78±0.44 | 2.21±0.93 | 0.65(0.22,2.08) | 72.78±10.16 | 84.78±25.91 | 18 627/6 310 | 5 604(22.47) | ||
| Q2组 | 4.96±1.02 | 1.58±0.34 | 2.41±0.85 | 0.77(0.30,2.10) | 73.59±10.14 | 80.82±24.67 | 19 681/5 259 | 4 510(18.08) | ||
| Q3组 | 5.07±1.04 | 1.46±0.34 | 2.45±0.90 | 0.90(0.35,2.40) | 74.01±10.20 | 81.43±23.38 | 20 249/4 689 | 4 795(19.23) | ||
| Q4组 | 4.92±1.46 | 1.36±0.36 | 2.33±0.95 | 1.06(0.41,2.76) | 74.66±10.16 | 80.89±27.98 | 21 140/3 800 | 4 992(20.02) | ||
| 检验统计量值 | 85.97 | 1.54 | 1.78 | 418.57a | 62.94 | 390.05 | 67.48b | 113.44b | ||
| P值 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | ||
| 组别 | 月人均收入≥800元[例(%)] | 体育锻炼[例(%)] | 饮酒史[例(%)] | 吸烟史[例(%)] | 糖尿病史[例(%)] | 高血压史[例(%)] | 血脂异常[例(%)] | 陈旧性心肌梗死[例(%)] | ||
| Q1组 | 3 836(15.38) | 22 912(91.88) | 9 477(38.00) | 8 267(33.15) | 1 303(5.23) | 8 500(34.09) | 8 980(36.01) | 14(0.06) | ||
| Q2组 | 3 231(12.96) | 22 886(91.76) | 8 370(33.56) | 7 822(31.36) | 1 873(7.51) | 10 720(42.98) | 10 302(41.31) | 21(0.08) | ||
| Q3组 | 3 538(14.19) | 22 693(91.00) | 9 148(36.68) | 8 620(34.57) | 2 604(10.44) | 11 855(47.54) | 15 653(62.77) | 26(0.10) | ||
| Q4组 | 3 729(14.95) | 22 602(90.63) | 10 223(40.99) | 9 661(38.74) | 3 620(14.51) | 13 256(53.15) | 24 517(98.30) | 25(0.11) | ||
| 检验统计量值 | 0.39b | 19.03b | 91.00b | 5.07b | 545.59b | 729.19b | 81.26b | 118.22b | ||
| P值 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 |
Table 1 Comparison of general situation of different AIP level groups
| 组别 | 例数 | AIP | 年龄(岁) | BMI (kg/m2) | WC (cm) | SBP (mmHg) | DBP (mmHg) | MAP (mmHg) | FBG (mmol/L) | TG [M(P25,P75),mmol/L] |
|---|---|---|---|---|---|---|---|---|---|---|
| Q1组 | 24 937 | -0.90±0.28 | 51.7±13.4 | 23.5±3.2 | 83.11±9.95 | 127±21 | 81±11 | 96±14 | 5.19±1.36 | 0.72(0.58,0.87) |
| Q2组 | 24 940 | -0.35±0.11 | 51.8±12.9 | 24.7±3.3 | 85.92±9.55 | 130±21 | 83±11 | 99±14 | 5.37±1.47 | 1.10(0.94,1.25) |
| Q3组 | 24 938 | 0.06±0.13 | 52.4±12.5 | 25.6±3.4 | 88.46±9.61 | 132±21 | 84±12 | 100±14 | 5.55±1.70 | 1.51(1.29,1.78) |
| Q4组 | 24 940 | 0.80±0.42 | 51.6±11.8 | 26.4±3.4 | 90.75±9.33 | 135±21 | 86±12 | 102±14 | 5.81±2.06 | 2.74(2.12,3.90) |
| 检验统计量值 | 86.68 | 1 981.21 | 219.42 | 532.90 | 979.11 | 260.10 | 652.22 | 128.82 | 119.10a | |
| P值 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | |
| 组别 | TC (mmol/L) | HDL-C (mmol/L) | LDL-C (mmol/L) | hs-CRP [M(P25,P75),mg/L] | HR (次/min) | eGFR [mL·(min)-1·(1.73 m2)-1] | 性别(男/女) | 高中及以上受教育程度[例(%)] | ||
| Q1组 | 4.84±0.97 | 1.78±0.44 | 2.21±0.93 | 0.65(0.22,2.08) | 72.78±10.16 | 84.78±25.91 | 18 627/6 310 | 5 604(22.47) | ||
| Q2组 | 4.96±1.02 | 1.58±0.34 | 2.41±0.85 | 0.77(0.30,2.10) | 73.59±10.14 | 80.82±24.67 | 19 681/5 259 | 4 510(18.08) | ||
| Q3组 | 5.07±1.04 | 1.46±0.34 | 2.45±0.90 | 0.90(0.35,2.40) | 74.01±10.20 | 81.43±23.38 | 20 249/4 689 | 4 795(19.23) | ||
| Q4组 | 4.92±1.46 | 1.36±0.36 | 2.33±0.95 | 1.06(0.41,2.76) | 74.66±10.16 | 80.89±27.98 | 21 140/3 800 | 4 992(20.02) | ||
| 检验统计量值 | 85.97 | 1.54 | 1.78 | 418.57a | 62.94 | 390.05 | 67.48b | 113.44b | ||
| P值 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | ||
| 组别 | 月人均收入≥800元[例(%)] | 体育锻炼[例(%)] | 饮酒史[例(%)] | 吸烟史[例(%)] | 糖尿病史[例(%)] | 高血压史[例(%)] | 血脂异常[例(%)] | 陈旧性心肌梗死[例(%)] | ||
| Q1组 | 3 836(15.38) | 22 912(91.88) | 9 477(38.00) | 8 267(33.15) | 1 303(5.23) | 8 500(34.09) | 8 980(36.01) | 14(0.06) | ||
| Q2组 | 3 231(12.96) | 22 886(91.76) | 8 370(33.56) | 7 822(31.36) | 1 873(7.51) | 10 720(42.98) | 10 302(41.31) | 21(0.08) | ||
| Q3组 | 3 538(14.19) | 22 693(91.00) | 9 148(36.68) | 8 620(34.57) | 2 604(10.44) | 11 855(47.54) | 15 653(62.77) | 26(0.10) | ||
| Q4组 | 3 729(14.95) | 22 602(90.63) | 10 223(40.99) | 9 661(38.74) | 3 620(14.51) | 13 256(53.15) | 24 517(98.30) | 25(0.11) | ||
| 检验统计量值 | 0.39b | 19.03b | 91.00b | 5.07b | 545.59b | 729.19b | 81.26b | 118.22b | ||
| P值 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 |
| 项目 | 模型1 | 模型2 | 模型3 | |||
|---|---|---|---|---|---|---|
| HR(95%CI) | P值 | HR(95%CI) | P值 | HR(95%CI) | P值 | |
| Q1组 | 1.000 | 1.000 | 1.000 | |||
| Q2组 | 1.09(0.98~1.21) | 0.106 | 0.98(0.88~1.09) | 0.729 | 0.98(0.88~1.08) | 0.645 |
| Q3组 | 1.41(1.28~1.56) | <0.001 | 1.18(1.06~1.30) | <0.001 | 1.16(1.05~1.28) | 0.005 |
| Q4组 | 1.53(1.39~1.69) | <0.001 | 1.22(1.10~1.35) | <0.001 | 1.20(1.08~1.33) | <0.001 |
| P趋势值 | <0.001 | <0.001 | <0.001 | |||
Table 2 Cox proportional risk regression analysis of new-onset heart failure influencing factors
| 项目 | 模型1 | 模型2 | 模型3 | |||
|---|---|---|---|---|---|---|
| HR(95%CI) | P值 | HR(95%CI) | P值 | HR(95%CI) | P值 | |
| Q1组 | 1.000 | 1.000 | 1.000 | |||
| Q2组 | 1.09(0.98~1.21) | 0.106 | 0.98(0.88~1.09) | 0.729 | 0.98(0.88~1.08) | 0.645 |
| Q3组 | 1.41(1.28~1.56) | <0.001 | 1.18(1.06~1.30) | <0.001 | 1.16(1.05~1.28) | 0.005 |
| Q4组 | 1.53(1.39~1.69) | <0.001 | 1.22(1.10~1.35) | <0.001 | 1.20(1.08~1.33) | <0.001 |
| P趋势值 | <0.001 | <0.001 | <0.001 | |||
| 项目 | 发病人数/总人数 | 模型3 | |
|---|---|---|---|
| HR(95%CI) | P值 | ||
| 排除2年内新发心力衰竭患者(n=297) | |||
| Q1组 | 615/24 877 | 1.000 | |
| Q2组 | 667/24 873 | 0.98(0.88~1.10) | 0.730 |
| Q3组 | 854/24 852 | 1.16(1.04~1.29) | 0.007 |
| Q4组 | 904/24 856 | 1.20(1.08~1.34) | <0.001 |
| P趋势值 | <0.001 | ||
| 排除随访期间发生恶性肿瘤事件患者(n=6 195) | |||
| Q1组 | 630/23 367 | 1.000 | |
| Q2组 | 687/23 376 | 0.97(0.87~1.08) | 0.593 |
| Q3组 | 883/23 362 | 1.16(1.05~1.29) | 0.005 |
| Q4组 | 918/23 455 | 1.19(1.07~1.33) | 0.001 |
| P趋势值 | <0.001 | ||
| 排除基线服用降脂药患者(n=932) | |||
| Q1组 | 660/24 802 | 1.000 | |
| Q2组 | 715/24 766 | 0.97(0.87~1.08) | 0.590 |
| Q3组 | 924/24 689 | 1.17(1.05~1.29) | 0.004 |
| Q4组 | 958/24 566 | 1.19(1.08~1.33) | <0.001 |
| P趋势值 | <0.001 | ||
Table 3 Sensitivity analysis of baseline AIP to the risk of new-onset heart failure
| 项目 | 发病人数/总人数 | 模型3 | |
|---|---|---|---|
| HR(95%CI) | P值 | ||
| 排除2年内新发心力衰竭患者(n=297) | |||
| Q1组 | 615/24 877 | 1.000 | |
| Q2组 | 667/24 873 | 0.98(0.88~1.10) | 0.730 |
| Q3组 | 854/24 852 | 1.16(1.04~1.29) | 0.007 |
| Q4组 | 904/24 856 | 1.20(1.08~1.34) | <0.001 |
| P趋势值 | <0.001 | ||
| 排除随访期间发生恶性肿瘤事件患者(n=6 195) | |||
| Q1组 | 630/23 367 | 1.000 | |
| Q2组 | 687/23 376 | 0.97(0.87~1.08) | 0.593 |
| Q3组 | 883/23 362 | 1.16(1.05~1.29) | 0.005 |
| Q4组 | 918/23 455 | 1.19(1.07~1.33) | 0.001 |
| P趋势值 | <0.001 | ||
| 排除基线服用降脂药患者(n=932) | |||
| Q1组 | 660/24 802 | 1.000 | |
| Q2组 | 715/24 766 | 0.97(0.87~1.08) | 0.590 |
| Q3组 | 924/24 689 | 1.17(1.05~1.29) | 0.004 |
| Q4组 | 958/24 566 | 1.19(1.08~1.33) | <0.001 |
| P趋势值 | <0.001 | ||
| 模型 | C指数(95%CI) | NRI(95%CI) | P值 | IDI(95%CI) | P值 |
|---|---|---|---|---|---|
| 原模型 | 0.791 8(0.762 9~0.820 7) | ||||
| 原模型+AIP | 0.792 3(0.763 5~0.821 1) | 0.134 5(0.002 6~0.266 4) | 0.046 | 0.000 1(-0.000 3~0.000 3) | 0.866 |
| 原模型+baPWV | 0.796 3(0.767 7~0.824 8) | 0.146 8(0.015 0~0.278 7) | 0.029 | 0.000 5(-0.000 7~0.001 7) | 0.406 |
Table 4 The predictive and discriminatory capabilities of different models for new-onset heart failure
| 模型 | C指数(95%CI) | NRI(95%CI) | P值 | IDI(95%CI) | P值 |
|---|---|---|---|---|---|
| 原模型 | 0.791 8(0.762 9~0.820 7) | ||||
| 原模型+AIP | 0.792 3(0.763 5~0.821 1) | 0.134 5(0.002 6~0.266 4) | 0.046 | 0.000 1(-0.000 3~0.000 3) | 0.866 |
| 原模型+baPWV | 0.796 3(0.767 7~0.824 8) | 0.146 8(0.015 0~0.278 7) | 0.029 | 0.000 5(-0.000 7~0.001 7) | 0.406 |
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