心血管疾病家族史和吸烟对缺血性脑卒中发病的联合效应

陆芹; 张建辉; 刘永跃; 陆红敏; 田芸凡; 布仁巴图; 周逸鹏; 张永红

Abstract

陆芹,张建辉,刘永跃,陆红敏,田芸凡,布仁巴图,周逸鹏,张永红.心血管疾病家族史和吸烟对缺血性脑卒中发病的联合效应[J].Chinese journal of Epidemiology,2016,37(4):475-479

心血管疾病家族史和吸烟对缺血性脑卒中发病的联合效应

Combined effects of both cardiovascular disease family history and smoking on the incidence of is chemic stroke

Received:August 11, 2015

DOI：10.3760/cma.j.issn.0254-6450.2016.04.007

KeyWord: 缺血性脑卒中心血管疾病家族史吸烟

English Key Word: Ischemic stroke Family history of cardiovascular disease Smoking

FundProject:国家自然科学基金(30972531)

Author Name	Affiliation	E-mail
Lu Qin	Department of Epidemiology, School of Public Health, Medical College of Soochow University/Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Disease, Soochow University, Suzhou 215123, China
Zhang Jianhui	Department of Internal Medicine-Neurology, Tongliao Municipal Hospital, Tongliao, Inner Mongolia 028000, China
Liu Yongyue	Tongliao Center for Disease Control and Prevention, Tongliao, Inner Mongolia 028000, China
Lu Hongmin	Department of Internal Medicine-Neurology, Tongliao Municipal Hospital, Tongliao, Inner Mongolia 028000, China
Tian Yunfan	Department of Epidemiology, School of Public Health, Medical College of Soochow University/Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Disease, Soochow University, Suzhou 215123, China
Buren Batu	Tongliao Center for Disease Control and Prevention, Tongliao, Inner Mongolia 028000, China
Zhou Yipeng	Department of Epidemiology, School of Public Health, Medical College of Soochow University/Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Disease, Soochow University, Suzhou 215123, China
Zhang Yonghong	Department of Epidemiology, School of Public Health, Medical College of Soochow University/Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Disease, Soochow University, Suzhou 215123, China	yhzhang@suda.edu.cn

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Abstract:

目的探讨蒙古族人群心血管疾病家族史和吸烟的联合作用与缺血性脑卒中事件发生的关系。方法 2002-2003年在完成2589名蒙古族研究对象基线调查的基础上,进行10年随访观察,将缺血性脑卒中作为终点事件。按心血管疾病家族史与吸烟状况将2589名研究对象分为无心血管疾病家族史/不吸烟、无心血管疾病家族史/吸烟、心血管疾病家族史/不吸烟、心血管疾病家族史/吸烟四组。以Kaplan-Meier(K-M)方法描述4个组研究对象的缺血性脑卒中累积发病率。应用Cox比例风险模型,估计发生缺血性脑卒中的风险比(HR)及其95%CI。结果 K-M分析结果显示,上述4个组的累积发病率分别为1.17%(15/1278)、3.83%(37/967)、5.70%(9/158)、8.33%(15/180)。经Cox模型分析,在调整年龄、男性、饮酒情况、SBP、DBP、BMI、FPG、TC、TG、LDL-C后,与无心血管疾病家族史/不吸烟组相比,无心血管疾病家族史/吸烟组、有心血管疾病家族史/吸烟组的HR值分别为2.26(95%CI:1.19~4.28)和2.45(95%CI:1.13~5.33),差异均有统计学意义(P<0.05),以心血管疾病家族史/吸烟组发生缺血性脑卒中的危险性最高。结论具有心血管疾病家族史的吸烟人群可增加缺血性脑卒中的危险性。

English Abstract:

Objective To investigate the cumulative effect regarding the family history of cardiovascular disease and smoking on ischemic stroke events in population with Mongolian ethnicity. Methods Based on data gathered from the baseline investigation, a 10-year prospective cohort follow-up project was conducted among 2589 participants with Mongolian ethnicity. Ischemic stroke events were defined as the outcomes of the study. All the 2589 participants were categorized into four subgroups:without family history of cardiovascular disease/nonsmokers, without family history of cardiovascular disease/smokers, with family history of cardiovascular disease/nonsmokers and with family history of cardiovascular disease/smokers, according to family history of cardiovascular disease and smoking status. Cumlative incidence rates of events among the four subgroups was described with Kaplan-Meier curves. Cox proportional hazards model was used to estimate the hazard ratios(HRs) and 95% confidence intervals(95%CI) of ischemic stroke events among the four subgroups. Results Data from the Kaplan-Meier curves showed that the cumulative incidence rates of ischemic stroke were 1.17%(15/1278), 3.83%(37/967), 5.70%(9/158) and 8.33%(15/180) for the groups of no family history of cardiovascular disease/nonsmokers, no family history of cardiovascular disease/smokers, with family history of cardiovascular disease/nonsmokers and with family history of cardiovascular disease/smokers, respectively. By cox proportional hazards model, after adjusting for age, male, drinking status, systolic and diastolic blood pressure, body mass index, fasting glucose, total cholesterol, triglycerides, LDL cholesterol factors, the HRs(95%CI) of ischemic stroke were 2.26(1.19-4.28) and 2.45(1.13-5.33) in the no family history of cardiovascular disease/smokers group, with family history of cardiovascular disease/smokers group when compared to the no family history of cardiovascular disease/nonsmokers group, respectively. The risk of ischemic stroke appeared the highest in the group with family history of cardiovascular disease/smokers(all P<0.05). Conclusion Smoking may increase the risk of ischemic stroke events among the population with family history of cardiovascular disease.

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