| 摘要: |
| 目的：探讨卒中预防策略实施过程中影响卒中发病的主要因素。方法：在干预队列人群中，采取1：2病例-对照研究方法，选择随访期间（1999～2001年）发生卒中的患者402例为病例组，选取未发生卒中的高危患者804例为对照组。比较病例和对照组间脑血管血液动力学指标（CVHI）的差异，对研究因素进行单因素和多因素Logistic回归分析。结果：病例组与对照组的CVHI积分均值分别为（31．85±20．01）分和（40．41±18．99）分（P〈0．001），且与卒中发病具有显著的剂量反应关系。单因素分析显示，高血压病是卒中发病的危险因素，服用重点干预药物是保护因素，其优势比OR（95％CI）分别为2．43（1．25，4．84）和0．43（0．33，0．55）。多因素Logistic回归分析显示，被筛选进入回归方程的因素依然是高血压病史、服用重点干预药物和CVHI积分筛检。结论：影响卒中发病的主要危险因素是高血压病和CVHI积分降低的程度，服用重点干预药物可显著降低卒中发病风险。 |
| 关键词: 脑血管意外 危险因素 病例对照研究 |
| DOI：10.3724/SP.J.1008.2007.00188 |
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| 基金项目:上海市政府专项基金[沪科合（99）第005号] |
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| Factors influencing stroke in an intervention population in Nanhui county of Shanghai： a case-control study |
| WANG Yan ,HUANG Jiu-yi ,CAO Yi-feng ,GUO Ji-ping ,YANG Yong-ju ,YU Xue-hai , SHEN Feng-ying ,WANG Gui- qing , QIAN Guo-zheng |
| (1. Shanghai Institute of Cerebrovascular Disease Prevention and Treatment, Shanghai 201318, China ; 2. Biomedical Engineering Research Division,Changhai Hospital,Second Military Medical University, Shanghai 200433) |
| Abstract: |
| Objective：To explore the factors influencing the incidence of stroke in an intervention population. Methods： A community based population aged 35 years old or over was cluster sampled from Shanghai Nanhui county. Individuals with at least one risk factor of stroke were selected to receive a cerebral vascular hemodynamic index （CVHI） examination. The patients with CVHI score below 70 were defined as high risk population and they received an intensive intervention based on general intervention for 3 years （1999-2001）. The present case control study included 402 stroke cases and 804 controls at high risk of stroke. The differences of CVHI were compared between 2 groups; the relationship between the studied factors and stroke was analyzed by univariate and multivariate Logistic regression. Results： The mean CVHI scores of case and control groups were 31.85±20.01 and 40.41±18.99, respectively （P〈0.001）. A significant dosage response was found between the decrease of CVHI score and the increase of stroke risk. Univariate analysis indicated that hypertension was the risk factor of stroke and taking key medication of intensive intervention was the protective factor of stroke, and their odds ratios （95% CI） were 2.43 （1.25,4.84） and 0.43 （0.33,0.55）, respectively. Multiple factors analysis showed that hypertension, taking key medication for intensive intervention, and screening by CVHI score were the independent influence factors of stroke. Conclusion： The primary risk factors of stroke are hypertension and the decrease of CVHI score; taking key medication of intensive intervention can markahly decrease the risk of stroke |
| Key words: cerebrovascular accident risk factors case-control studies |
