【作者】 李莉；

【导师】 蔡亚平；

【作者基本信息】 南华大学 ， 卫生毒理学， 2007， 硕士

【摘要】 目的:深入探讨缺血性脑卒中发病的危险因素,为控制、预防缺血性脑卒中的发生,提供切实可行的科学依据。方法:采用1: 1配对病例对照研究,收集病例和对照各100例,采用统一的缺血性脑卒中流行病学调查表,对所有对象进行调查,内容包括:一般情况、生活方式、既往病史、脑血管病家族史、体格检查、血脂、血糖、血浆同型半胱氨酸浓度。用生活事件量表(Life Events Scale,LES)调查精神压力与缺血性脑卒中发病的关系。采用配对病例对照研究方法分析危险因素对缺血性脑卒中的影响。结果:1.配对t检验分析显示,缺血性脑卒中组的血清总胆固醇、甘油三脂、低密度脂蛋白胆固醇、血糖、血浆同型半胱氨酸、LES总分明显高于对照组,高密度脂蛋白胆固醇明显低于对照组(P<0.05)。2.配对χ2检验分析显示,吸烟、饮酒、高血压、糖尿病、心脏病、脑血管病家族史与缺血性脑卒中的发病有关(P<0.05);经趋势χ2检验分析,高血压、日吸烟量、日饮酒量、血浆同型半胱氨酸与缺血性脑卒中的发病之间存在等级趋势(P<0.05)。3.多元线性逐步回归分析显示,血浆同型半胱氨酸水平与胆固醇和高血压密切相关。4.多因素条件Logistic回归(全变量回归法)分析显示,胆固醇、吸烟、血浆同型半胱氨酸、高血压、心脏病为影响缺血性脑卒中发病的独立危险因素。其OR and OR95%CI分别是2.006 (1.089,5.149),1.646 (1.004,4.964),1.367(1.007,3.674),3.010 (1.031,8.798),2.457 (1.002,6.731)。结论:1.高血压、心脏病、高血脂、吸烟、高同型半胱氨酸血症是缺血性脑卒中的危险因素。2.高血压、血浆同型半胱氨酸水平与缺血性脑卒中的发病有剂量反应关系。3.血浆同型半胱氨酸水平与胆固醇和高血压密切相关。更多还原

【Abstract】 Objectives: To comprehensively explore the risk factors of ischemic cerebral stroke and offer feasible , scientific proof for the precaution of ischemic cerebral stroke.Methods: A 1:1case-control study of 100 pairs was carried out. All of the objects were investigated in uniform questionnaire about suspected risk factor which included population feature, living style, past medical history, family history of cerebrovascular disease, physical examination,blood glucose, blood fat,blood homocysteic acid. Life Events Scale(LES) was used to investigate the relationship between stress and ischemic stroke. All of the data were processed with method of pair case-control .Results:1. Pair T test analysis showed that TC、TG、LDL-L、BG、Hcy、total score of LES of the case were significantly higher than those of the control, HDL-L is lower(P<0.05).2. Pairχ2 test analysis showed that smoking、drinking、hypertension、diabetes、heart disease、family cerebrovascular disease history were related to ischemic cerebral stroke (P<0.05); Trendχ2 test analysis showed that there were trend relationship between hypertension、amount of everyday smoking and drinking、blood plasma Hcy and ischemic cerebral stroke.3. Multiple linear stepwise regression analysis showed that there were close correlation between TC、hypertension and blood plasma Hcy.4. Multiple condition logistic regression analysis showed that TC、smoking、blood plasma Hcy、hypertension、heart disease were independent risk factors of ischemic cerebral stroke, OR and OR95%CI were 2.006 (1.089,5.149),1.646 (1.004,4.964), 1.367(1.007, 3.674),3.010 (1.031,8.798),2.457 (1.002,6.731)respectively.Conclusions:1.The most important risk factors leading to ischemic cerebral stroke were hyperten- sion、heart disease.、TC、smoking、hyperhomocysteinemia. 2. There are dose response relationship between hypertension、blood plasma Hcy and ischemic cerebral stroke.3. There are close correlation between TC、hypertension and blood plasma Hcy.更多还原