文章摘要
李学松,黄久仪,郭吉平,顾桢茂,刘广西,张懿,蔡珍璋,王艳.队列人群出血性卒中和缺血性卒中危险因素的对比研究[J].中华流行病学杂志,2023,44(9):1383-1389
队列人群出血性卒中和缺血性卒中危险因素的对比研究
Comparison of risk factors for hemorrhagic stroke and ischemic stroke, a prospective long-term follow-up cohort study
收稿日期:2023-02-10  出版日期:2023-09-14
DOI:10.3760/cma.j.cn112338-20230210-00069
中文关键词: 出血性卒中  缺血性卒中  危险因素  队列研究
英文关键词: Hemorrhagic stroke  Ischemic stroke  Risk factors  Cohort study
基金项目:
作者单位E-mail
李学松 上海市脑血管病防治研究所, 上海 200063  
黄久仪 上海市脑血管病防治研究所, 上海 200063  
郭吉平 上海市脑血管病防治研究所, 上海 200063  
顾桢茂 上海市脑血管病防治研究所, 上海 200063  
刘广西 上海市脑血管病防治研究所, 上海 200063  
张懿 上海市脑血管病防治研究所, 上海 200063  
蔡珍璋 上海市脑血管病防治研究所, 上海 200063  
王艳 上海市脑血管病防治研究所, 上海 200063 wangyan1997@aliyun.com 
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中文摘要:
      目的 分析与比较出血性卒中和缺血性卒中危险因素及其暴露水平的差异。方法 2003年在上海市奉贤区某农村社区建立卒中危险因素研究队列,对常见的卒中危险因素进行基线调查,检测脑血管血流动力学指标,按照统一的积分规则计算脑血管功能积分,随访卒中的发病。用队列研究的方法分析出血性卒中和缺血性卒中的危险因素,对2种亚型卒中的危险因素进行分析和比较。结果 纳入研究的队列人群10 565例,随访(11.15±2.26)年,新发生出血性卒中103例,缺血性卒中268例。脑血管功能积分降低、饮酒史、高血压病史和年龄升高是出血性卒中的独立危险因素,风险比(HR)值分别为1.56(95%CI:1.23~1.98)、2.46(95%CI:1.39~4.34)、1.75(95%CI:1.00~3.07)和1.07(95%CI:1.04~1.10)。脑血管功能积分降低、吸烟史、高血压病史、卒中家族史、左心室肥厚和年龄升高是缺血性卒中的独立危险因素,HR值分别为1.43(95%CI:1.25~1.65)、1.52(95%CI:1.13~2.05)、1.51(95%CI:1.10~2.07)、1.89(95%CI:1.13~3.15)、1.74(95%CI:1.07~2.81)和1.07(95%CI:1.05~1.08)。结论 脑血管功能积分降低、高血压病史、年龄升高是出血性卒中和缺血性卒中共同的独立危险因素,饮酒史是出血性卒中的独立危险因素,吸烟史、卒中家族史和左心室肥厚是缺血性卒中的独立危险因素。
英文摘要:
      Objective To analyze and compare the risk factors for hemorrhagic stroke and ischemic stroke and understand the exposure levels in population. Methods A cohort study of risk factors of stroke was conducted in a rural community in Fengxian District of Shanghai in 2003, and the common risk factors of stroke were investigated at baseline survey, the cerebrovascular hemodynamics indexes were detected, the cerebrovascular function score was calculated according to the unified integral rule, and the incidence of stroke was observed in follow up. The risk factors for hemorrhagic stroke and ischemic stroke were analyzed by cohort study. The risk factors for two subtypes of stroke were compared. Result A total of 10 565 participants were included in the study, with a mean follow-up period of (11.15±2.26) years, and 103 hemorrhagic stroke cases and 268 ischemic stroke cases were observed during follow-up period. The independent risk factors of hemorrhagic stroke included decreased cerebrovascular function score[hazard ratio (HR)=1.56, 95%CI:1.23-1.98], history of alcohol consumption (HR=2.46, 95%CI:1.39-4.34), hypertension (HR=1.75, 95%CI:1.00-3.07) and older age (HR=1.07, 95%CI:1.04-1.10). The independent risk factors of ischemic stroke included decreased cerebrovascular function score (HR=1.43, 95%CI: 1.25-1.65), smoking history (HR=1.52, 95%CI:1.13-2.05), hypertension (HR=1.51, 95%CI:1.10-2.07), family history of stroke (HR=1.89, 95%CI:1.13-3.15), left ventricular hypertrophy (HR=1.74, 95%CI:1.07-2.81) and older age (HR=1.07, 95%CI:1.05-1.08). Conclusions Decreased cerebrovascular function score, hypertension, and older age were common independent risk factors of both types of stroke, alcohol consumption history was an independent risk factor of hemorrhagic stroke, and smoking history, and family history of stroke and left ventricular hypertrophy were independent risk factors of ischemic stroke.
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