Fowkes F G, Lee A J, Evans C J, Allan P L, Bradbury A W, Ruckley C V
Wolfson Unit for Prevention of Peripheral Vascular Diseases, Public Health Sciences, Department of Medical Radiology, University of Edinburgh, Edinburgh, UK.
Int J Epidemiol. 2001 Aug;30(4):846-52. doi: 10.1093/ije/30.4.846.
Varicose veins occur commonly in the general population but the aetiology is not well established. Varicosities are associated frequently with reflux of blood in the leg veins due to valvular incompetence. Our aim was to determine in the general population which lifestyle factors were related to reflux and thus implicated in the aetiology of varicose veins.
In the Edinburgh Vein Study, 1566 men and women aged 18-64 years were sampled randomly from the general population in the city of Edinburgh, Scotland, and had duplex scans to measure reflux in eight venous segments in each leg. A self-administered questionnaire enquired about occupation, mobility at work, smoking, obstetric history, dietary fibre intake and bowel habit. A bowel record form was completed subsequently.
In women, venous reflux was associated with decreased sitting at work (odds ratio [OR] = 0.76, 95% CI : 0.61-0.94), previous pregnancy (OR = 1.20, 95% CI : 0.93-1.54), and a lower prior use of oral contraceptives (OR = 0.84, 95% CI : 0.66-1.06). Mean body mass index was greater in women with superficial reflux compared to those with no reflux: 26.2 kg/m(2) (95% CI : 25.5-27.0) versus 25.2 kg/m(2) (95% CI : 24.8-25.6). On age adjustment, sitting at work remained related to reflux (OR = 0.78, 95% CI : 0.63-0.98) and prior use of oral contraceptives to superficial reflux (OR = 0.71, 95% CI : 0.50-1.01). In age-adjusted analyses in men, height was related to reflux, (OR = 1.13, 95% CI : 1.02-1.26) and straining at stool was related to superficial reflux (OR = 1.94, 95% CI : 1.12-3.35). No associations were found in either sex between reflux and social class, lifetime cigarette consumption, dietary fibre intake and intestinal transit time.
This population study did not identify strong and consistent lifestyle risk factors for venous reflux although previous pregnancy, lower use of oral contraceptives, obesity and mobility at work in women and height and straining at stool in men may be implicated.
静脉曲张在普通人群中很常见，但其病因尚未完全明确。静脉曲张常与因瓣膜功能不全导致的腿部静脉血液反流有关。我们的目的是在普通人群中确定哪些生活方式因素与反流有关，从而推断其在静脉曲张病因中的作用。
在爱丁堡静脉研究中，从苏格兰爱丁堡市的普通人群中随机抽取了1566名年龄在18 - 64岁之间的男性和女性，对他们每条腿的八个静脉节段进行双功扫描以测量反流情况。通过一份自填式问卷询问其职业、工作时的活动情况、吸烟情况、产科病史、膳食纤维摄入量和排便习惯。随后填写一份排便记录表格。
在女性中，静脉反流与工作时坐姿减少（比值比[OR]=0.76，95%可信区间：0.61 - 0.94）、既往怀孕（OR = 1.20，95%可信区间：0.93 - 1.54）以及以前口服避孕药的使用较少（OR = 0.84，95%可信区间：0.66 - 1.06）有关。与无反流的女性相比，有浅静脉反流的女性平均体重指数更高：26.2kg/m²（95%可信区间：25.5 - 27.0）对25.2kg/m²（95%可信区间：24.8 - 25.6）。经年龄调整后，工作时坐姿仍与反流有关（OR = 0.78，95%可信区间：0.63 - 0.98），口服避孕药的既往使用与浅静脉反流有关（OR = 0.71，95%可信区间：0.50 - 1.01）。在对男性进行的年龄调整分析中，身高与反流有关（OR = 1.13，95%可信区间：1.02 - 1.26），用力排便与浅静脉反流有关（OR = 1.94，95%可信区间：1.12 - 3.35）。在反流与社会阶层、终生吸烟量、膳食纤维摄入量和肠道转运时间之间，未发现两性中有任何关联。
尽管既往怀孕、口服避孕药使用较少、女性工作时的活动情况以及男性的身高和用力排便可能与之有关，但这项人群研究未发现与静脉反流相关的强有力且一致的生活方式风险因素。
