Screening for abdominal aortic aneurysm: lessons from a population-based study
Screening for abdominal aortic aneurysm: lessons from a population-based study
复制标题
DOI：
10.5694/j.1326-5377.2000.tb125684.x
复制
发表时间：
2000-10-02
影响因子：
11.4
通讯作者：
Dickinson, JA
中科院分区：
文献类型：
--
作者：
Jamrozik, K;Norman, PE;Dickinson, JA
目的：测试筛查的可接受性，并确定男性腹主动脉瘤（AAA）的可改变危险因素。设计：一项以人群为基础的65-83岁男性随机样本的AAA超声筛查试验，以及同一样本中男性的横断面病例对照比较。参与者：12203名男子，他们接受了腹主动脉超声检查，并完成了一份涵盖人口、行为和医学因素的调查问卷。主要结局指标：AAA患病率，以及AAA与人口统计学、医学和生活方式因素的独立关联。结果：邀请筛选产生了70.5%的纠正反应。AAAs （bbb30 mm）的患病率从65-69岁男性的4.8%上升到80-83岁男性的10.8%。大动脉瘤（bbb50 mm）的总发生率为0.69%。在一个多因素logistic模型中，地中海出生的男性患AAA的风险比澳大利亚出生的男性低40% （bbb30毫米）（比值比[OR]， 0.6; 95% CI, 0.4-0.8），而戒烟者患AAA的风险显著增加（OR, 2.3; 95% CI, 1.9-2.8），目前吸烟者的风险甚至更高。AAA与已确诊的冠状动脉和外周动脉疾病以及腰臀比大于0.9显著相关；经常进行剧烈运动的男性风险较低（OR, 0.8; 95% CI, 0.7-1.0）。结论：在可能的目标人群中，超声筛查AAA是可以接受的。AAA具有闭塞性血管疾病的一些危险因素，但不是全部，但在晚年初级预防AAA的范围是有限的。
Objectives: To test the acceptability of screening and to identify modifiable risk factors for abdominal aortic aneurysm (AAA) in men.Design: A trial of ultrasound screening for AAA in a population-based random sample of men aged 65-83 years, and a cross-sectional case-control comparison of men in the same sample.Participants: 12203 men who had an ultrasound examination of their abdominal aorta, and completed a questionnaire covering demographic, behavioural and medical factors.Main outcome measures: Prevalence of AAA, and independent associations of AAA with demographic, medical and lifestyle factors.Results: Invitations to screening produced a corrected response of 70.5%. The prevalence of AAAs (> 30 mm) rose from 4.8% in men aged 65-69 years to 10.8% in those aged 80-83 years. The overall prevalence of large (> 50 mm) aneurysms was 0.69%. In a multivariate logistic model Mediterranean-born men had a 40% lower risk of AAA (> 30 mm) compared with men born in Australia (odds ratio [OR], 0.6; 95% CI, 0.4-0.8), while ex-smokers had a significantly increased risk of AAA (OR, 2.3; 95% CI, 1.9-2.8), and current smokers had even higher risks. AAA was significantly associated with established coronary and peripheral arterial disease and a waist:hip ratio greater than 0.9; men who regularly undertook vigorous exercise had a lower risk (OR, 0.8; 95% CI, 0.7-1.0). Conclusion: Ultrasound screening for AAA is acceptable to men in the likely target population. AAA shares some but not all of the risk factors for occlusive vascular disease, but the scope for primary prevention of AAA in later life is limited.