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本文报告了上海市18个里委15885人脑血管病危险因素前瞻性队列研究1987—1990年(36216人年)随访的结果。用单因素分析的方法分析了几种因素和脑卒中之间的关系,发现高血压病家族史(相对危险度,RR=5.18),高血压病史(RR=4.14),现症高血压(RR=5.14).心脏病(RR=3.22),糖尿病(RR=4.64)和肥胖(RR=2.01),是明显的脑卒中危险因素。血清高密度脂蛋白(HDL)增高,对出血性脑卒中似有一定的危险作用(RR=1.69),而HDL降低则对脑卒中似有一定的保护作用(RR=0.74)。对出血和缺血性脑中风的分别分析以及按性别分层分析发现,实测舒张期血压升高(≥21.28kPa)对出血性和缺血性脑卒中的危险度男(RR=5.48)和女性(RR=4.22)均较高,而对出血性脑卒中仅在男性是危险因素(RR=6.22),在女性无意义(RR=0.9,P>0.05)。糖尿病仅对缺血性脑卒中有危险性,在男性RR值为16.66,在女性RR值为12.76,而和出血性脑卒无联系。吸烟仅在女性为出血性和缺血性脑卒中的危险因素,RR值分别为1.80和2.47,而在男性则不显著。血清甘油三酯升高对女性的出血和缺血性脑卒中似有保护作用(RR=0.55),但不显著(P>0.05)。男女性血清HDL降低均为出血性脑卒中的保护因素,其RR值分别为0.32和0.47,但HDL增高在男性为出血性脑卒中的危险因素(RR=3.48),任缺血性脑卒中则正好
This article reports the results of a prospective cohort study of 15,885 people with risk factors of cerebrovascular disease in 18 committees in Shanghai from 1987 to 1990 (36,216 person-years). The relationship between several factors and stroke was analyzed by univariate analysis. The family history of hypertension (relative risk, RR = 5.18), history of hypertension (RR = 4.14), prevalence of hypertension = 5.14), heart disease (RR = 3.22), diabetes mellitus (RR = 4.64) and obesity (RR = 2.01) were significant risk factors for stroke. Increased serum high density lipoprotein (HDL) may have some dangerous effect on hemorrhagic stroke (RR = 1.69), while decreased HDL may have a protective effect on stroke (RR = 0.74). Separate analysis of bleeding and ischemic stroke and stratified by sex found that measured diastolic blood pressure (≥21.28 kPa) had a significantly higher risk of hemorrhagic and ischemic stroke in men (RR = 5.48) and in women (RR = 4.22) were higher, but hemorrhagic stroke was the only risk factor in males (RR = 6.22), and no significance in females (RR = 0.9, P> 0.05). Diabetes is only at risk for ischemic stroke, with a RR of 16.66 in males and a RR of 12.76 in females, with no association with hemorrhagic stroke. Smoking was a risk factor for hemorrhagic and ischemic stroke in women only, with RRs of 1.80 and 2.47, respectively, whereas smoking was not significant in men. Elevated serum triglycerides may have protective effects on bleeding and ischemic stroke in women (RR = 0.55), but not significantly (P> 0.05). Serum HDL levels decreased in both men and women as protective factors for hemorrhagic stroke, with RRs of 0.32 and 0.47, respectively. However, elevated HDL was associated with a risk factor for hemorrhagic stroke in men (RR = 3.48) and ischemic stroke Exactly