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背景和目的本指南提供有关各种确定和潜在的卒中危险因素证据的概述,并提供降低卒中风险的推荐。方法写作组成员由委员会主席根据每位作者先前在相关课题领域中的工作提名,并经美国心脏协会(AHA)卒中委员会科学声明监督委员会批准。写作组采用系统文献回顾(涵盖时间段为2001年最后一次回顾发表到2005年1月),参考先前已发表的指南、个人文件和专家意见来概括现有的证据,指明现有知识的差距;如果合适,则根据标准的AHA标准做出简明的推荐。写作组全体成员在撰写过程中均有很多机会对推荐进行评论并认可这份声明的最终版本。在AHA科学咨询与协调委员会批准之前,本指南已进行过广泛的同行评议。结果对评价个体首次卒中风险的流程图进行评估。根据干预的可能性(不可干预、可干预或潜在可干预)和证据的强度(证据充分或证据不太充分),对首次卒中的危险因素或风险标记物进行分类。不可干预的危险因素包括年龄、性别、出生体重低、人种/种族和遗传因素。证据充分的可干预危险因素包括高血压、主动或被动吸烟、糖尿病、心房颤动和某些其他心脏病、血脂异常、颈动脉狭窄、镰状细胞病、绝经后激素治疗、不良饮食习惯、缺乏体力活动、肥胖和体脂分布。证据不太充分或潜在的可干预危险因素包括代谢综合征、酗酒、药物滥用、口服避孕药、睡眠呼吸障碍、偏头痛、高同型半胱氨酸血症、脂蛋白(a)升高、脂蛋白相关的磷脂酶升高、高凝状态、炎症和感染。对应用阿司匹林进行卒中一级预防的资料进行回顾。结论有大量证据可以用于确定增加首次卒中风险的各种特殊因素和提供降低这种风险的策略。
Background and Objectives This guide provides an overview of the various identified and potential evidence of stroke risk factors and provides recommendations for reducing the risk of stroke. Methods The writing group members are nominated by the chair of the committee on the basis of each author’s previous work in the subject area and approved by the AHA Stroke Council Scientific Statement Oversight Committee. The writing group used a systematic review of the literature (covering a time period from the last retrospective of 2001 to January 2005), summarizing existing evidence with reference to previously published guidelines, personal papers and expert opinions, indicating gaps in existing knowledge; If appropriate, make concise recommendations based on the standard AHA standards. All members of the writing team have many opportunities to comment on the recommendation and approve the final version of the statement during the writing process. This guide has undergone extensive peer review before it is approved by the AHA Scientific Advisory and Coordinating Committee. Results The flow chart for assessing the risk of first stroke in an individual was assessed. The first stroke risk factor or risk marker is classified according to the likelihood of intervention (not intervened, intervened, or potentially intervened) and the strength of the evidence (insufficient or insufficient evidence). Unadjigable risk factors include age, gender, low birth weight, race / race and genetic factors. Evidence of adequate risk factors for intervention include hypertension, active or passive smoking, diabetes mellitus, atrial fibrillation and certain other heart diseases, dyslipidemia, carotid stenosis, sickle cell disease, postmenopausal hormone therapy, poor eating habits, lack of physical strength Activity, obesity and body fat distribution. Insufficient evidence or potential interventions for risk factors include metabolic syndrome, alcoholism, substance abuse, oral contraceptives, sleep-disordered breathing, migraine, hyperhomocysteinemia, elevated lipoprotein (a), elevated lipid Elevated protein-related phospholipases, hypercoagulable state, inflammation and infection. Review data on primary prevention of stroke with aspirin. Conclusion There is a wealth of evidence that can be used to identify the specific factors that increase the risk of first stroke and to provide strategies to reduce this risk.