Criqui Michael H, Denenberg Julie O, Bergan John, Langer Robert D, Fronek Arnost
Department of Family and Preventive Medicine, University of California, San Diego, CA, USA.
J Vasc Surg. 2007 Aug;46(2):331-7. doi: 10.1016/j.jvs.2007.03.052. Epub 2007 Jun 27.
The etiology of chronic venous disease in the lower limbs is unclear, and very limited data are available on potential risk factors from representative population studies.
Participants in the San Diego Population Study, a free-living adult population randomly selected from age, sex, and ethnic strata, were systematically assessed for risk factors for venous disease. Categorization of normal, moderate, and severe disease was determined hierarchically through clinical examination and ultrasonography imaging by trained vascular technologists, who also performed anthropometric measures. An interviewer administered a questionnaire and an examination assessed potential risk factors for venous disease suggested by previous reports.
In multivariable models, moderate venous disease was independently related to age, a family history of venous disease, previous hernia surgery, and normotension in both sexes. In men, current walking, the absence of cardiovascular disease, and not moving after sitting were also predictive. Additional predictors in women were weight, number of births, oophorectomy, flat feet, and not sitting. For severe disease, age, family history of venous disease, waist circumference, and flat feet were predictive in both sexes. In men, occupation as a laborer, cigarette smoking, and normotension were also independently associated with severe venous disease. Additional significant and independent predictors in women were hours standing, history of leg injury, number of births, and cardiovascular disease, but African American ethnicity was protective. Multiple other postulated risk factors for venous disease were not significant in multivariable analysis in this population.
Although some risk factors for venous disease such as age, family history of venous disease, and findings suggestive of ligamentous laxity (hernia surgery, flat feet) are immutable, others can be modified, such as weight, physical activity, and cigarette smoking. Overall, these data provide modest support for the potential of behavioral risk-factor modification to prevent chronic venous disease.
下肢慢性静脉疾病的病因尚不清楚，来自代表性人群研究的潜在风险因素数据非常有限。
圣地亚哥人群研究的参与者是从年龄、性别和种族阶层中随机选取的自由生活成年人群，对其静脉疾病风险因素进行了系统评估。由训练有素的血管技术人员通过临床检查和超声成像对正常、中度和重度疾病进行分级分类，他们还进行了人体测量。访员发放问卷，检查评估先前报告中提示的静脉疾病潜在风险因素。
在多变量模型中，中度静脉疾病与年龄、静脉疾病家族史、既往疝气手术以及两性的血压正常独立相关。在男性中，当前的步行情况、无心血管疾病以及久坐后不活动也具有预测性。女性的其他预测因素包括体重、生育次数、卵巢切除术、扁平足和不坐着。对于重度疾病，年龄、静脉疾病家族史、腰围和扁平足在两性中均具有预测性。在男性中，体力劳动者职业、吸烟和血压正常也与重度静脉疾病独立相关。女性中其他显著且独立的预测因素包括站立时间、腿部受伤史、生育次数和心血管疾病，但非裔美国人种族具有保护作用。该人群多变量分析中，其他多种假定的静脉疾病风险因素不显著。
尽管静脉疾病的一些风险因素，如年龄、静脉疾病家族史以及提示韧带松弛的表现（疝气手术、扁平足）是不可改变的，但其他因素可以改变，如体重、体力活动和吸烟。总体而言，这些数据为通过改变行为风险因素预防慢性静脉疾病的可能性提供了一定支持。
