郑州市农村地区脑卒中家族史人群脑卒中危险因素调查分析
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摘要
目的研究郑州市农村地区脑卒中家族史人群脑卒中的相关危险因素。方法采用随机整群抽样的方法抽取河南省郑州市郊县5个村庄有脑卒中家族史的386人为调查对象进行调查,并根据结果分为脑卒中组和非脑卒中组。运用IBM SPSS STATISTICS 21.0和SPSS Modeler 14.1软件对数据进行统计分析。结果与非脑卒中组相比,脑卒中组既往有高血压、血脂异常、心房纤颤或心律不齐、吸烟、饮酒的比例更高,差异均有统计学意义(P <0.05)。Logistic回归分析得出高血压(OR=35.705,95%CI:9.045～140.950,P=0.000)、血脂异常(OR=2.669,95%CI:1.077～6.614,P=0.034)是脑卒中的危险因素。ANN模型按照影响因素重要性排序结果为:高血压、血脂异常、吸烟、饮酒、心房纤颤或心律不齐。模型测试集的准确率为82.0%。结论对于有脑卒中家族史的人群来说,既往有高血压、血脂异常、心房纤颤动或心律不齐、吸烟、饮酒者更易发展为脑卒中。
Objective To investigate the risk factors for stroke in population with family history in rural areas of Zhengzhou. Methods A cluster random sampling method was used to collect 386 residents with family history of stroke from 5 villages of Zhengzhou. The participants were divided into stroke group and non-stroke group according to diagnosis. IBM SPSS STATISTICS 21.0 and SPSS Modeler 14.1 software were used to analyze the data.Results Hypertension, dyslipidemia,atrial fibrillation or arrhythmia,smoking and drinking in stroke group were significantly higher than those of the non-stroke group(P < 0.05). Logistic regression analysis indicated that hypertension(OR=35.705,95% CI9.045～140.950,P =0.000) and dyslipidemia(OR=2.669,95% CI 1.077～6.614,P = 0.034) were linked with stroke. Artificial neural network(ANN) model indicated the independent variables in predicting stroke were hypertension, dyslipidemia, smoking, drinking and atrial fibrillation or arrhythmia according significance, respectively. The accuracy of the model was 82.0%. Conclusion Among population with family history of stroke,those who had hypertension, dyslipidemia, atrial fibrillation or arrhythmia, smoking and drinking were more susceptible to develop this condition.
Objective To investigate the risk factors for stroke in population with family history in rural areas of Zhengzhou. Methods A cluster random sampling method was used to collect 386 residents with family history of stroke from 5 villages of Zhengzhou. The participants were divided into stroke group and non-stroke group according to diagnosis. IBM SPSS STATISTICS 21.0 and SPSS Modeler 14.1 software were used to analyze the data.Results Hypertension, dyslipidemia,atrial fibrillation or arrhythmia,smoking and drinking in stroke group were significantly higher than those of the non-stroke group(P < 0.05). Logistic regression analysis indicated that hypertension(OR=35.705,95% CI9.045～140.950,P =0.000) and dyslipidemia(OR=2.669,95% CI 1.077～6.614,P = 0.034) were linked with stroke. Artificial neural network(ANN) model indicated the independent variables in predicting stroke were hypertension, dyslipidemia, smoking, drinking and atrial fibrillation or arrhythmia according significance, respectively. The accuracy of the model was 82.0%. Conclusion Among population with family history of stroke,those who had hypertension, dyslipidemia, atrial fibrillation or arrhythmia, smoking and drinking were more susceptible to develop this condition.
引文
[1]AMARENCO P."Telethrombolysis":stroke consultation by telemedicine[J].Lancet Neurol,2008,7(9):763-765.
[2]TSIVGOULIS G,PATOUSI A,PIKILIDOU M,et al.Stroke incidence and outcomes in Northeastern Greece:The evros stroke registry[J].Stroke,2018,49(2):288-295.
[3]中国卒中学会,卒中后认知障碍管理专家委员会.卒中后认知障碍管理专家共识[J].中国卒中杂志,2017,12(6):519-531.
[4]WANG W,JIANG B,SUN H,et al.Prevalence,incidence,and mortality of stroke in China results from a nationwide population-based survey of 480 687 adults[J].Circulation,2017,135(8):759.
[5]CHAUHAN G,DEBETTE S.Genetic risk factors for ischemic and hemorrhagic stroke[J].Curr Cardiol Rep,2016,18(12):124.
[6]WILSON S L,POULTER N R.Cardiovascular risk:its assessment in clinical practice[J].Brit J Biomed Sci,2001,58(4):248-251.
[7]中国营养学会.中国居民膳食指南(2007版)[M].拉萨:西藏人民出版社,2007:1-13.
[8]陈春明,孔灵芝.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006:2-12.
[9]洪诸权,康建翼,潘莹.血清同型半胱氨酸对冠状动脉粥样硬化性心脏病患者脑卒中发病的影响[J].中国现代医学杂志,2016,26(3):68-71.
[10]DUMONT T M,RUGHANI A I,TRANMER B I.Prediction of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage with an artificial neural network:feasibility and comparison with logistic regression models[J].World Neurosurg,2011,75(1):57-63,25-28.
[11]董文涛,张振,靳张宁,等.脑卒中家族史人群的脑卒中危险因素筛查[J].天津医药,2015,43(7):807-809.
[12]BENJAMIN E J,VIRANI S S,CALLAWAY C W,et al.Heart disease and stroke statistics-2018 update:a report from the american heart association[J].Circulation,2018,137(12):e67-e492.
[13]潘双杰,何远宏,王楠.首发缺血性卒中患者短期预后评价模型[J].实用医学杂志,2016,32(19):3238-3241.
[14]LIU M,WU B,WANG W Z,et al.Stroke in China:epidemiology,prevention,and management strategies[J].Lancet Neurol,2007,6(5):456-464.
[15]O'DONNELL M J,XAVIER D,LIU L,et al.Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries(the INTERSTROKE study):a case-control study[J].Lancet,2010,376(9735):112-123.
[16]刘岩,吕新云,陈硕,等.表现为孤立性急性前庭综合征的脑梗死的临床分析:附15例报道[J].中华神经医学杂志,2018,17(1):34-38.
[17]付睿,戴威,岳云龙,等.皮层微梗死的临床危险因素及高场强磁共振成像研究[J].中华神经医学杂志,2017,16(9):876-880.
[18]王薇,赵冬,刘静,等.中国35~64岁人群血压水平与10年心血管病发病危险的前瞻性研究[J].中华内科杂志,2004,43(10):14-18.
[19]杨孟霞.杭州市社区居民脑卒中患病情况及知信行调查[J].中国老年学杂志,2016,36(6):1477-1479.
[20]AS S,SAHUKAR S,MURTHY J,et al.A study of serum apolipoprotein A1,apolipoprotein B and lipid profile in stroke[J].JClin Diagn Res,2013,7(7):1303-1306.
[21]LEE B C,LIN C L,TSAI H H,et al.Statin and the risk of ischemic stroke or transient ischemic attack in head and neck cancer patients with radiotherapy[J].J Stroke,2018,20(3):413-414.
[22]YANG X,LI J,HU D,et al.Predicting the 10-year risks of atherosclerotic cardiovascular disease in Chinese population:the China-PAR project(prediction for ASCVD risk in China)[J].Circulation,2016,134(19):1430.
[23]BENJAMIN E J,BLAHA M J,CHIUVE S E,et al.Heart disease and stroke statistics-2017 update:a report from the American heart association[J].Circulation,2017,135(10):e146-e603.
[24]ZHANG C,QIN Y Y,CHEN Q,et al.Alcohol intake and risk of stroke:a dose-response meta-analysis of prospective studies[J].Int J Cardiol,2014,174(3):669-677.
[25]ECKEL N,MEIDTNER K,KALLE-UHLMANN T,et al.Metabolically healthy obesity and cardiovascular events:A systematic review and meta-analysis[J].Eur J Prev Cardiol,2016,23(9):956-966.
[2]TSIVGOULIS G,PATOUSI A,PIKILIDOU M,et al.Stroke incidence and outcomes in Northeastern Greece:The evros stroke registry[J].Stroke,2018,49(2):288-295.
[3]中国卒中学会,卒中后认知障碍管理专家委员会.卒中后认知障碍管理专家共识[J].中国卒中杂志,2017,12(6):519-531.
[4]WANG W,JIANG B,SUN H,et al.Prevalence,incidence,and mortality of stroke in China results from a nationwide population-based survey of 480 687 adults[J].Circulation,2017,135(8):759.
[5]CHAUHAN G,DEBETTE S.Genetic risk factors for ischemic and hemorrhagic stroke[J].Curr Cardiol Rep,2016,18(12):124.
[6]WILSON S L,POULTER N R.Cardiovascular risk:its assessment in clinical practice[J].Brit J Biomed Sci,2001,58(4):248-251.
[7]中国营养学会.中国居民膳食指南(2007版)[M].拉萨:西藏人民出版社,2007:1-13.
[8]陈春明,孔灵芝.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006:2-12.
[9]洪诸权,康建翼,潘莹.血清同型半胱氨酸对冠状动脉粥样硬化性心脏病患者脑卒中发病的影响[J].中国现代医学杂志,2016,26(3):68-71.
[10]DUMONT T M,RUGHANI A I,TRANMER B I.Prediction of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage with an artificial neural network:feasibility and comparison with logistic regression models[J].World Neurosurg,2011,75(1):57-63,25-28.
[11]董文涛,张振,靳张宁,等.脑卒中家族史人群的脑卒中危险因素筛查[J].天津医药,2015,43(7):807-809.
[12]BENJAMIN E J,VIRANI S S,CALLAWAY C W,et al.Heart disease and stroke statistics-2018 update:a report from the american heart association[J].Circulation,2018,137(12):e67-e492.
[13]潘双杰,何远宏,王楠.首发缺血性卒中患者短期预后评价模型[J].实用医学杂志,2016,32(19):3238-3241.
[14]LIU M,WU B,WANG W Z,et al.Stroke in China:epidemiology,prevention,and management strategies[J].Lancet Neurol,2007,6(5):456-464.
[15]O'DONNELL M J,XAVIER D,LIU L,et al.Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries(the INTERSTROKE study):a case-control study[J].Lancet,2010,376(9735):112-123.
[16]刘岩,吕新云,陈硕,等.表现为孤立性急性前庭综合征的脑梗死的临床分析:附15例报道[J].中华神经医学杂志,2018,17(1):34-38.
[17]付睿,戴威,岳云龙,等.皮层微梗死的临床危险因素及高场强磁共振成像研究[J].中华神经医学杂志,2017,16(9):876-880.
[18]王薇,赵冬,刘静,等.中国35~64岁人群血压水平与10年心血管病发病危险的前瞻性研究[J].中华内科杂志,2004,43(10):14-18.
[19]杨孟霞.杭州市社区居民脑卒中患病情况及知信行调查[J].中国老年学杂志,2016,36(6):1477-1479.
[20]AS S,SAHUKAR S,MURTHY J,et al.A study of serum apolipoprotein A1,apolipoprotein B and lipid profile in stroke[J].JClin Diagn Res,2013,7(7):1303-1306.
[21]LEE B C,LIN C L,TSAI H H,et al.Statin and the risk of ischemic stroke or transient ischemic attack in head and neck cancer patients with radiotherapy[J].J Stroke,2018,20(3):413-414.
[22]YANG X,LI J,HU D,et al.Predicting the 10-year risks of atherosclerotic cardiovascular disease in Chinese population:the China-PAR project(prediction for ASCVD risk in China)[J].Circulation,2016,134(19):1430.
[23]BENJAMIN E J,BLAHA M J,CHIUVE S E,et al.Heart disease and stroke statistics-2017 update:a report from the American heart association[J].Circulation,2017,135(10):e146-e603.
[24]ZHANG C,QIN Y Y,CHEN Q,et al.Alcohol intake and risk of stroke:a dose-response meta-analysis of prospective studies[J].Int J Cardiol,2014,174(3):669-677.
[25]ECKEL N,MEIDTNER K,KALLE-UHLMANN T,et al.Metabolically healthy obesity and cardiovascular events:A systematic review and meta-analysis[J].Eur J Prev Cardiol,2016,23(9):956-966.