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通过冠状动脉造影分析确定的日本出租车司机冠心病特征。

Characteristics of coronary heart disease in Japanese taxi drivers as determined by coronary angiographic analyses.

作者信息

Kurosaka K, Daida H, Muto T, Watanabe Y, Kawai S, Yamaguchi H

机构信息

Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.

出版信息

Ind Health. 2000 Jan;38(1):15-23. doi: 10.2486/indhealth.38.15.

Abstract

Several epidemiological studies have shown that the prevalence of ischemic heart disease is higher in occupational drivers than in people with other occupations. Although occupation categories can be surrogate measures for coronary risk factors, the relationships between taxi driving and severity of coronary heart disease (CHD) has not been investigated. Even more important, the contribution of risk factors to the severity of CHD in taxi drivers remains unclear. Our study tested the hypothesis that taxi driving could be associated with the severity of CHD. We also examined the relation between this occupation and risk factors and social lifestyle. We analyzed the coronary angiograms of 57 consecutive male taxi driver patients and compared them with those of 215 age-adjusted male non-taxi-driver patients. The number of diseased vessels and risk factors were compared between two groups. The prevalence of myocardial infarction and multi-vessel disease was higher in the taxi-driver patients than in the non-taxi-driver patients. The taxi-driver patients had higher prevalence of body mass index (BMI), diabetes, and smoking, higher levels of low-density lipoprotein cholesterol (LDL-C), and lower levels of apolipoprotein AI (ApoAI). Multiple logistic regression analysis showed that multi-vessel disease was associated with BMI and diabetes mellitus in taxi-driver patients. The taxi-driver patients were characterized by more extensive coronary atherosclerosis associated with higher prevalence of diabetes mellitus and obesity. These characteristics may be explained by in part their working environment.

摘要

多项流行病学研究表明,职业司机患缺血性心脏病的患病率高于从事其他职业的人群。尽管职业类别可作为冠状动脉危险因素的替代指标,但出租车驾驶与冠心病(CHD)严重程度之间的关系尚未得到研究。更重要的是,危险因素对出租车司机冠心病严重程度的影响仍不明确。我们的研究检验了出租车驾驶可能与冠心病严重程度相关的假设。我们还研究了这种职业与危险因素及社会生活方式之间的关系。我们分析了57例连续的男性出租车司机患者的冠状动脉造影,并将其与215例年龄匹配的男性非出租车司机患者的造影进行比较。比较了两组的病变血管数量和危险因素。出租车司机患者中心肌梗死和多支血管病变的患病率高于非出租车司机患者。出租车司机患者的体重指数(BMI)、糖尿病和吸烟患病率更高,低密度脂蛋白胆固醇(LDL-C)水平更高,载脂蛋白AI(ApoAI)水平更低。多因素逻辑回归分析显示,出租车司机患者的多支血管病变与BMI和糖尿病有关。出租车司机患者的特点是冠状动脉粥样硬化更广泛,糖尿病和肥胖患病率更高。这些特征部分可能与其工作环境有关。

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