林岫芳,陈剑,周智娟.心血管疾病与睡眠呼吸暂停综合征的相关研究[J].Chinese journal of Epidemiology,2004,25(8):654 |
心血管疾病与睡眠呼吸暂停综合征的相关研究 |
Multi-state model in the evaluation of outcome on mild cognitive impairment to Alzheimer's disease |
Received:December 04, 2003 |
DOI: |
KeyWord: 心血管疾病 高血压 |
English Key Word: Alzhcimer's disease|Mild cognitive impairment|Malti—state model|Outcome |
FundProject:国家自然科学基金(30972545);山西省留学回国人员科技活动择优项目;山西医科大学科技创新项目 |
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Abstract: |
睡眠呼吸暂停综合征(OSAS)易诱发高血压、心肌缺血、心律失常以及碎死,我们对1998年以来收治的高血压、冠心病、心律失常患者与OSAS的关系进行了分析. |
English Abstract: |
Objective The aim of this study was to introduce the multi—slate Markov modelfor the prediction of mild cognitive impairment(MCI)to AIzheimer’S diseaselAD)and to find out the related factors for AD preventionan dearly in tervention among tile elderly.Methods MCI.moderate to severe cognitive impairment.and AD were defined as state 1.2 and 3,respectively.A three—state homogeneous model with discrete states and discrete times from data six follow—up visits was constructed to explore factors for various progressive stages from MCI to AD.Transition probability and survival curve were madeafter the model fit as sessment.Results At the level of 0.05,data from the multivariate analysis showed that gender(HR=1.23,95%c,:1.12一1.38).age(HR=l.37,95%G/:L071~72), hypertension (HR=1.54,95%C/:1.3一2. 19) were statistically significant for the transition from state I to state 2. while age(HR=O.78,95%C1:0.69—0.98).education level(HR=1.35. 95%Cl:1.09一lr86)and reading(HR=1.20,95%c,:1.01一1.41)were:statistically significant for transition from state 2 to state l,and gander(HR=1.59,95%C/:1.33一1.89), age(HR=1.33,95%C/:1.02-1.64), hypertension(HR=1.22,95%C/:1.1l一1.43).diabetes(HR=1.52,95%CI:1.12—2. 00),ApoEe4(HR=1.44. 95%CI:1.09—1.68)were statistically significant for transition from statc 2 to slate 3.Based 0n the fired modeI,the three-yeart ransition probabilities during each state at average covariate Ievel were estimated.Conclusion To delay the disease progression of MCI.phase by phase prevention measures could be adopted based On the main factors of each stage.Multi-state Markov model could imitate the naturalhistory of disease and showed great advantage in dynamically evaluating the development of chronic diseases with multi-states and multi-factors. |
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