汇集队列风险方程在健康体检者脑卒中风险预测中的应用
|
摘要
目的比较汇集队列风险方程(PCE)和改良Framingham卒中风险评估量表(R-FSP)在健康体检人群卒中风险评估中的应用效果,为预防人群卒中提供指导依据。方法 2017年1～12月随机抽取于宜宾市第二人民医院健康管理中心体检的40～70岁健康体检者1 277名,采用R-FSP和PCE评估其10年卒中风险,比较M-FSP和PCE在卒中风险评估应用中的一致性。结果采用R-FSP和PCE评估1 277名健康体检者的10年卒中风险概率分别为5.8%和6.1%。R-FSP预测卒中风险男性(6.0%)高于女性(5.5%),PCE预测结果也一致(男vs女:6.5%vs 5.7%),R-FSP预测BMI≥24 kg/m2者卒中风险(6.5%)高于BMI<24 kg/m2(5.5%),PCE预测结果也一致(≥24 kg/m2vs <24 kg/m2:6.8%vs 5.9%);R-FSP预测40～50岁、50～60岁和60～70岁年龄段体检者卒中风险概率分别为3.6%、5.9%和9.2%,PCE预测结果分别为4.0%、6.0%、9.9%,差异均有统计学意义(P<0.05);R-FSP和PCE评估卒中风险结果有高度一致性,其Pearson相关系数和组内相关系数(ICC)分别为0.719和0.757 (P<0.05)。结论 R-FSP和PCE均能较好地预测卒中发生风险概率,研究者可以根据实际情况选择合适的预测工具。
Objective To compare the applications of pooled cohort risk equations(PCE) and revised Framingham stroke risk profile(R-FSP) in predicting the risk of stroke among physical examiners, and to provide effective strategy for preventing stroke. Methods From January 2017 to December 2017, 1 277 physical examiners were selected randomly from No.2 Peoples' Hospital of Yibin to assess their 10 years stroke risk by R-FSP and PCE, and the consistency of R-FSP and PCE in stroke risk assessment was compared. Results The probability of stroke predicted by R-FSP and PCE was 5.8% and 6.1% respectively among 1 277 physical examiners, with male(6.0%) higher than female(5.5%) by R-FSP, and the same tendency predicted by PCE(male vs female: 6.5% vs 5.7%); the probability of stroke predicted by R-FSP for the patients with BMI≥24 kg/m2(6.5%) was higher than BMI<24 kg/m2(5.5%), with the same tendency predicted by PCE(≥24 kg/m2 vs <24 kg/m2: 6.8% vs 5.9%). The probability of stroke predicted by R-FSP for 40-50 years old, 50-60 years old and 60-70 years old were respectively 3.6%, 5.9%, 9.2% versus corresponding 4.0%, 6.0%, 9.9%predicted by PCE(all P<0.05). The results of stroke risk predicted by R-FSP and PCE was high consistency with Pearson correlation coefficient(0.719) and intraclass correlation coefficient(0.757), P<0.05. Conclusion R-FSP and PCE are suited to predict the probability of stroke with high consistency, and researchers could select appropriate prediction tools according to distinctive situation.
Objective To compare the applications of pooled cohort risk equations(PCE) and revised Framingham stroke risk profile(R-FSP) in predicting the risk of stroke among physical examiners, and to provide effective strategy for preventing stroke. Methods From January 2017 to December 2017, 1 277 physical examiners were selected randomly from No.2 Peoples' Hospital of Yibin to assess their 10 years stroke risk by R-FSP and PCE, and the consistency of R-FSP and PCE in stroke risk assessment was compared. Results The probability of stroke predicted by R-FSP and PCE was 5.8% and 6.1% respectively among 1 277 physical examiners, with male(6.0%) higher than female(5.5%) by R-FSP, and the same tendency predicted by PCE(male vs female: 6.5% vs 5.7%); the probability of stroke predicted by R-FSP for the patients with BMI≥24 kg/m2(6.5%) was higher than BMI<24 kg/m2(5.5%), with the same tendency predicted by PCE(≥24 kg/m2 vs <24 kg/m2: 6.8% vs 5.9%). The probability of stroke predicted by R-FSP for 40-50 years old, 50-60 years old and 60-70 years old were respectively 3.6%, 5.9%, 9.2% versus corresponding 4.0%, 6.0%, 9.9%predicted by PCE(all P<0.05). The results of stroke risk predicted by R-FSP and PCE was high consistency with Pearson correlation coefficient(0.719) and intraclass correlation coefficient(0.757), P<0.05. Conclusion R-FSP and PCE are suited to predict the probability of stroke with high consistency, and researchers could select appropriate prediction tools according to distinctive situation.
引文
[1]Feigin VL,Roth GA,Naghavi M,et al.Global burden of stroke and risk factors in 188 countries,during 1990-2013:a systematic analysis for the Global Burden of Disease Study 2013[J].Lancet Neurol,2016,15(9):913-924.
[2]Niewada M,Michel P.Lifestyle modification for stroke prevention:facts and fiction[J].Curr Opin Neurol,2016,29(1):9-13.
[3]Goff DC Jr,Lloyd-Jones DM,Bennett G,et al.2013 ACC/AHAguideline on the assessment of cardiovascular risk:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guideline[J].Circulation,2014,129(25 suppl 2):S49-73.
[4]Dufouil C,Beiser A,Mclure LA,et al.Revised Framingham stroke risk profile to reflect temporal trends[J].Circulation,2017,135(12):1145-1159.
[5]孙佳艺,巢宝华,徐新娟,等.中国三甲医院高血压患者脑卒中十年发病风险的流行病学研究[J].中华高血压杂志,2014,22(10):964-968.
[6]Muntner P,Colantonio LD,Cushman M,et al.Validation of the atherosclerotic cardiovascular disease Pooled Cohort risk equations[J].JAMA,2014,311(14):1406-1415.
[7]Benjamin EJ,Virani SS,Callaway CW,et al.Heart disease and stroke statistics-2018 update:a report from the American heart association[J].Circulation,2018,137(12):e67-e492.
[8]Chen Z,Jiang B,Ru X,et al.Mortality of stroke and its subtypes in China:results from a nationwide population-based survey[J].Neuroepidemiology,2017,48(3-4):95-102.
[9]Wang J,Wen X,Li W,et al.Risk factors for stroke in the Chinese population:a systematic review and meta-analysis[J].J Stroke Cerebrovasc Dis,2017,26(3):509-517.
[10]Mok Y,Sang Y,Ballew SH,et al.American Heart Association's life's simple 7 at middle age and prognosis after myocardial infarction in later life[J].J Am Heart Assoc,2018,7(4):e007658.
[11]Parmar P,Krishnamurthi R,Ikram MA,et al.The stroke riskometer?APP:validation of a data collection tool and stroke risk predictor[J].Int J Stroke,2015,10(2):231-244.
[12]Hasan TH,Habib KR,Nuzhat E,et al.Association of National Institute Health Stroke Scale(NIHSS)score on admission with the outcome of acute ischemic stroke at discharge from hospital[J].J Medicine,2018,19(2):91-94.
[13]Bos D,Ikram MA,Mjg L,et al.The revised Framingham Stroke Risk Profile in a primary prevention population:the otterdam study[J].Circulation,2017,135(22):2207-2209.
[14]黄久仪,曹奕丰,郭吉平,等.应用改良弗明汉卒中风险评估工具预测中国人卒中的风险[J].中国脑血管病杂志,2013,10(5):228-232.
[15]黄晓芸,付文金,梅志忠,等.改良FSP、CVHI联合Lp-PLA2预测脑卒中[J].新医学,2017,48(7):467-471.
[16]郭咏娣,武剑.508例脑卒中风险人群的颈动脉粥样硬化与Framingham卒中风险评分的相关性研究[J].中华老年心脑血管病杂志,2016,18(8):863-865.
[17]Muntner P,Colantonio LD,Cushman M,et al.Validation of the atherosclerotic cardiovascular disease Pooled Cohort risk equations[J].JAMA,2014,311(14):1406-1415.
[18]王拥军.变革创新,开启ASCVD防治新时代-2013AHA/ACC降低成人动脉粥样硬化性心血管疾病风险胆固醇治疗指南述评[J].中国卒中杂志,2014,9(1):9-12.
[19]Lee CH,Woo YC,Lam JK,et al.Validation of the Pooled Cohort equations in a long-term cohort study of Hong Kong Chinese[J].JClin Lipidol,2015,9(5):640-646.
[20]Chia YC,Lim HM,Ching SM.Validation of the pooled cohort risk score in an Asian population-a retrospective cohort study[J].BMCCardiovasc Disord,2014,14(1):163-169.
[21]Wang H,Sun Y,Yi X,et al.Evaluation of the Framingham risk score and pooled cohort risk equation for prediction of cardiovascular risk in low resource areas:insights from Asian rural population[J].Int JCardiol,2018,265:237.
[22]Topel ML,Shen J,Morris AA,et al.Comparisons of the Framingham and Pooled cohort equation risk scores for detecting subclinical vascular disease in blacks versus whites[J].Am J Cardiol,2017,121(5):564-569.
[23]Yang X,Li J,Hu D,et al.Predicting the 10-year risks of atherosclerotic cardiovascular disease in Chinese population:the China-PARproject(prediction for ASCVD risk in China)[J].Circulation,2016,134(19):1430-1440.
[24]唐迅,张杜丹,何柳,等.China-PAR模型在北方农村人群中预测动脉粥硬化性心血管疾病发病风险的应用[J].北京大学学报(医学版),2017,49(3):439-445.
[2]Niewada M,Michel P.Lifestyle modification for stroke prevention:facts and fiction[J].Curr Opin Neurol,2016,29(1):9-13.
[3]Goff DC Jr,Lloyd-Jones DM,Bennett G,et al.2013 ACC/AHAguideline on the assessment of cardiovascular risk:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guideline[J].Circulation,2014,129(25 suppl 2):S49-73.
[4]Dufouil C,Beiser A,Mclure LA,et al.Revised Framingham stroke risk profile to reflect temporal trends[J].Circulation,2017,135(12):1145-1159.
[5]孙佳艺,巢宝华,徐新娟,等.中国三甲医院高血压患者脑卒中十年发病风险的流行病学研究[J].中华高血压杂志,2014,22(10):964-968.
[6]Muntner P,Colantonio LD,Cushman M,et al.Validation of the atherosclerotic cardiovascular disease Pooled Cohort risk equations[J].JAMA,2014,311(14):1406-1415.
[7]Benjamin EJ,Virani SS,Callaway CW,et al.Heart disease and stroke statistics-2018 update:a report from the American heart association[J].Circulation,2018,137(12):e67-e492.
[8]Chen Z,Jiang B,Ru X,et al.Mortality of stroke and its subtypes in China:results from a nationwide population-based survey[J].Neuroepidemiology,2017,48(3-4):95-102.
[9]Wang J,Wen X,Li W,et al.Risk factors for stroke in the Chinese population:a systematic review and meta-analysis[J].J Stroke Cerebrovasc Dis,2017,26(3):509-517.
[10]Mok Y,Sang Y,Ballew SH,et al.American Heart Association's life's simple 7 at middle age and prognosis after myocardial infarction in later life[J].J Am Heart Assoc,2018,7(4):e007658.
[11]Parmar P,Krishnamurthi R,Ikram MA,et al.The stroke riskometer?APP:validation of a data collection tool and stroke risk predictor[J].Int J Stroke,2015,10(2):231-244.
[12]Hasan TH,Habib KR,Nuzhat E,et al.Association of National Institute Health Stroke Scale(NIHSS)score on admission with the outcome of acute ischemic stroke at discharge from hospital[J].J Medicine,2018,19(2):91-94.
[13]Bos D,Ikram MA,Mjg L,et al.The revised Framingham Stroke Risk Profile in a primary prevention population:the otterdam study[J].Circulation,2017,135(22):2207-2209.
[14]黄久仪,曹奕丰,郭吉平,等.应用改良弗明汉卒中风险评估工具预测中国人卒中的风险[J].中国脑血管病杂志,2013,10(5):228-232.
[15]黄晓芸,付文金,梅志忠,等.改良FSP、CVHI联合Lp-PLA2预测脑卒中[J].新医学,2017,48(7):467-471.
[16]郭咏娣,武剑.508例脑卒中风险人群的颈动脉粥样硬化与Framingham卒中风险评分的相关性研究[J].中华老年心脑血管病杂志,2016,18(8):863-865.
[17]Muntner P,Colantonio LD,Cushman M,et al.Validation of the atherosclerotic cardiovascular disease Pooled Cohort risk equations[J].JAMA,2014,311(14):1406-1415.
[18]王拥军.变革创新,开启ASCVD防治新时代-2013AHA/ACC降低成人动脉粥样硬化性心血管疾病风险胆固醇治疗指南述评[J].中国卒中杂志,2014,9(1):9-12.
[19]Lee CH,Woo YC,Lam JK,et al.Validation of the Pooled Cohort equations in a long-term cohort study of Hong Kong Chinese[J].JClin Lipidol,2015,9(5):640-646.
[20]Chia YC,Lim HM,Ching SM.Validation of the pooled cohort risk score in an Asian population-a retrospective cohort study[J].BMCCardiovasc Disord,2014,14(1):163-169.
[21]Wang H,Sun Y,Yi X,et al.Evaluation of the Framingham risk score and pooled cohort risk equation for prediction of cardiovascular risk in low resource areas:insights from Asian rural population[J].Int JCardiol,2018,265:237.
[22]Topel ML,Shen J,Morris AA,et al.Comparisons of the Framingham and Pooled cohort equation risk scores for detecting subclinical vascular disease in blacks versus whites[J].Am J Cardiol,2017,121(5):564-569.
[23]Yang X,Li J,Hu D,et al.Predicting the 10-year risks of atherosclerotic cardiovascular disease in Chinese population:the China-PARproject(prediction for ASCVD risk in China)[J].Circulation,2016,134(19):1430-1440.
[24]唐迅,张杜丹,何柳,等.China-PAR模型在北方农村人群中预测动脉粥硬化性心血管疾病发病风险的应用[J].北京大学学报(医学版),2017,49(3):439-445.