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目的探讨广东佛山社区无症状人群大脑中动脉(MCA)狭窄的危险因素和动态变化的影响因素,为社区人群脑卒中的预防提供流行病学上的帮助。方法2002年整群随机抽取2500名社区居民进行流行病学问卷、人体测量学、经颅多普勒超声(TCD)和血浆同型半胱氨酸(Hcy)水平等各项指标的数据收集,筛选出符合入选标准的观察对象1068例。4年后对观察对象复查相同指标,存留有效样本844例。依据大脑中动脉 TCD 检查的结果将其分为狭窄组和非狭窄组。使用 SPSS13.0对各项指标进行处理。结果2002年和2006年社区无症状人群大脑中动脉患病率分别为2.73%、4.62%。2002年非狭窄组2006年狭窄患病牢为1.9%。对2002年数据的 Logistic 同归分析筛选出糖尿病史,高 Hcy 血症为大脑中动脉的危险因素;4年后的数据显示,糖尿病史、高 Hcy、高血压史和冠心病史是大脑中动脉的危险因素,婚姻状况亦可能对大脑中动脉狭窄存在影响。纵向动态分析证实,冠心病、糖尿病史和体重指数等因素的动态变化也对大脑中动脉狭窄的发生起重要作用(均 P<0.05)。结论社区无症状人群存在大脑中动脉狭窄,糖尿病史、高血压病史、冠心病史和高Hcy 血症是其危险因素。心血管疾病的发生、肥胖的改变对大脑中动脉狭窄的发生也起着一定的作用。
Objective To investigate the risk factors and the dynamic changes of middle cerebral artery (MCA) stenosis in asymptomatic people in community of Foshan, Guangdong Province, and to provide epidemiological help for the prevention of stroke in community population. Methods A total of 2,500 community residents were randomly selected from the whole population in 2002 for data collection and screening of epidemiological questionnaires, anthropometry, transcranial Doppler (TCD) and plasma homocysteine (Hcy) Out of the 1068 patients who met the inclusion criteria. After 4 years, the same indicators were reviewed on the observation subjects, and 844 valid samples were retained. According to the results of TCD examination of middle cerebral artery, it was divided into stenosis group and non-stenosis group. Using SPSS13.0 to deal with the indicators. Results The prevalence rates of middle cerebral artery in asymptomatic subjects in community in 2002 and 2006 were 2.73% and 4.62% respectively. The prevalence of stenosis in the non-stenosis group in 2002 was 1.9%. Logistic regression analysis on 2002 data screened the history of diabetes, high Hcy hyperlipidemia as a risk factor for the middle cerebral artery; 4 years after the data show that the history of diabetes, high Hcy, history of hypertension and coronary heart disease is the middle cerebral artery Risk factors, marital status may also affect the stenosis of the middle cerebral artery. Longitudinal dynamic analysis confirmed that coronary heart disease, diabetes history and body mass index and other dynamic factors also play an important role in the occurrence of cerebral artery stenosis (P <0.05). Conclusions There is a risk factor for the presence of middle cerebral artery stenosis, diabetes mellitus, history of hypertension, history of coronary heart disease and hyperhomocysteinemia in asymptomatic community of community. Cardiovascular disease, obesity changes on the occurrence of cerebral artery stenosis also plays a role.