壓力、生活型態因子與冠狀動脈心臟病之病例對照研究

A case-control study on stress and lifestyle factors in relation to coronary heart disease

陳俊朋(Jun-Peng Chen)

指導教授 ： 王理

中山醫學大學/健康管理學院/公共衛生學系碩士班/碩士(2011年)

https://doi.org/10.6834/CSMU.2011.00112

摘要

研究目的：探討台灣民眾的壓力及生活型態因子與冠狀動脈心臟病發生的關係。
材料方法：本研究以醫院為基礎的病例對照研究，病例組在心臟內科門診，對照組在家庭醫學科與體檢中心做為研究對象，人數分別為245位病例組與394位對照組納入研究。以結構式問卷收集資料，由訪員對受訪者進行訪談。統計分析以邏輯斯迴歸進行分析。
研究結果：壓力與喝酒、吸菸、身體活動量、綠茶、心理健康、高血壓及糖尿病、炸烤醃製肉類、蔬果類與肉類有相關性。調整多變項後，有中度壓力(AOR=2.61，95%CI＝1.45-4.71)與高度壓力(AOR=2.05，95%CI＝1.15-3.64)時，會增加罹患冠狀動脈心臟病的危險，且有劑量效應關係(P-trend=0.005)。在冠狀動脈心臟病與各危險因子之雙變項分析中，發現處於高度壓力者，在過量飲酒(OR=6.40，95%CI＝2.40-17.08)、吸菸習慣(OR=5.85，95%CI=2.83-12.09)、低身體活動量(OR=3.75，95%CI=1.80-7.81)、低綠茶攝取量(OR=3.21，95%CI=1.78-5.77)、高度心理困擾(OR=2.52，95%CI=1.05-6.02)、炸烤醃製肉類攝取程度高(OR=6.32，95%CI= 2.58-15.49)、蔬果類攝取程度低(OR=6.76，95%CI=1.99-22.87)與肉類攝取程度高(OR=8.63，95%CI=3.57-20.83)，以及有高血壓(OR=4.24，95%CI=2.27-7.94)和糖尿病(OR=8.10，95%CI=3.37-19.48)，對於罹患冠狀動脈心臟病均有顯著的危險。
結論：壓力會增加冠狀動脈心臟病的危險，壓力與生活型態因子會相互影響，進而增加冠狀動脈心臟病的危險。

關鍵字

壓力 ； 生活型態 ； 冠狀動脈心臟病

並列摘要

Objective: The purpose of this study is to examine the association between stress and lifestyle factors and the risk of coronary heart disease in Taiwan.
Methods: This is a hospital-based case-control study. The subjects of case group were from the outpatient of cardiac internal department. The subjects of control group were recruited from outpatient of family medicine and those who come to hospital for regular health screening. There were 245 samples in the case group and 394 samples in the control group. The study was personally interviewed face-to-face by an interviewer using a structured questionnaire to collect information. Statistical analysis was adopted by logistic regression in this study.
Results: Stress was found to be associated with alcohol, smoking, physical activity, green tea, mental health, history of hypertension and diabetes, consumption of fried, grilled and salty foods, vegetables, fruits and meats. After adjusting other variables, moderate levels of stress (AOR=2.61，95%CI＝1.45-4.71) and high levels of stress (AOR=2.05，95%CI＝1.15-3.64) have been found to increase the risk of coronary heart disease with a significant trend (P-trend=0.005). Bivariate stratified analyses showed that there is a significant positive association between high levels of stress and coronary heart disease in patients, who also have higher levels of alcohol consumption (OR=6.40，95%CI＝2.40-17.08), cigarette smoking (OR=5.85，95%CI=2.83-12.09), low levels of physical activity (OR=3.75，95%CI=1.80-7.81), low levels of green tea consumption (OR=3.21，95%CI=1.78-5.77), high levels of distress (OR=2.52，95%CI=1.05-6.02), high levels of fried, grilled and salty food consumption (OR=6.32，95%CI= 2.58-15.49), low levels of vegetable and fruit consumption (OR=6.76，95%CI=1.99-22.87), high levels of meat consumption (OR=8.63，95%CI=3.57-20.83), a history of hypertension (OR=4.24，95%CI=2.27-7.94) and diabetes (OR=8.10，95%CI=3.37-19.48).
Conclusions: Stress increases the risk of coronary heart disease. Stress and some lifestyle factors would affect each other, thereby increasing the risk of coronary heart disease.

並列關鍵字

stress ； lifestyle ； coronary heart disease

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