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目的了解社区人群血脂水平与脑血流动力学综合指标的关系,为脑卒中预防和危险因素研究提供参考。方法2012年8-12月,整群抽取上海奉贤区2个社区55~79岁的人群5 153人,基线调查时测定脑血流动力学检测指标(CVHI)和空腹血脂水平,根据统一的规则计算CVHI综合积分,并按最佳截断点将研究对象分为CVHI积分值≥75分组和<75分组,比较两组间血脂水平,分析血脂水平与CVHI积分值的关系,并进行多因素logistic回归分析。结果研究人群年龄为(64.2±6.4)岁,男性2 209例(42.87%),女性2 944例(57.13%)。男性、女性CVHI积分值<75分组的TG水平均显著高于≥75分组,差异均有统计学意义(t值分别为3.995和6.920,P<0.01)。两组研究对象间的TC水平差异均无统计学意义(P>0.05)。女性65~69岁年龄组CVHI积分<75分组的低密度脂蛋白胆固醇水平显著高于≥75分组,差异有统计学意义(t=2.078,P<0.05),其余年龄组两组研究对象的低密度脂蛋白胆固醇水平差异均无统计学意义(P>0.05)。男性、女性CVHI积分值<75分组高密度脂蛋白胆固醇水平均显著低于≥75分组,差异均有统计学意义(t值分别为-3.104和-6.912,P<0.01)。多因素logistic回归分析结果显示,高密度脂蛋白胆固醇水平是CVHI积分值降低的保护因素,年龄、高血压病史、糖尿病病史、超重或肥胖、左心室肥厚、房颤病史、甘油三酯水平和男性为危险因素,其OR值及95%CI分别为0.774(0.598~1.002)、1.075(1.064~1.088)、2.172(1.871~2.521)、2.044(1.625~2.571)、1.684(1.516~1.870)、2.057(1.593~2.657)、2.051(1.080~3.894)、1.179(1.092~1.273)和1.543(1.326~1.796)。结论甘油三酯水平升高和高密度脂蛋白水平降低与脑血管功能受损密切相关,可能是脑血管功能损害的独立影响因素。
Objective To understand the relationship between the level of serum lipids and the comprehensive index of cerebral hemodynamics in community population and provide references for the prevention and risk factors of stroke. METHODS: From August to December 2012, 5 153 persons aged 55-79 years from two communities in Fengxian District of Shanghai were enrolled in this study. The cerebral hemodynamic parameters (CVHI) and fasting blood lipid levels were measured at baseline. According to the uniform rules The CVHI integrated score was calculated and the subjects were divided into CVHI ≥75 group and <75 group according to the best cut-off point. The level of blood lipids was compared between the two groups. The relationship between the level of lipid and CVHI score was analyzed and multivariate logistic regression analysis. Results The study population was (64.2 ± 6.4) years old with 2,209 (42.87%) men and 2,944 (57.13%) females. The TG levels of CVHI <75 in both men and women were significantly higher than those in ≥75 group (t = 3.995 and 6.920 respectively, P <0.01). There was no significant difference in TC levels between the two groups (P> 0.05). Female 65-69 age group CVHI score <75 group of low-density lipoprotein cholesterol levels were significantly higher than ≥ 75 group, the difference was statistically significant (t = 2.078, P <0.05), the remaining age group two subjects were low There was no significant difference in the levels of LDL cholesterol (P> 0.05). Male and female CVHI score <75 group HDL cholesterol levels were significantly lower than ≥ 75 group, the difference was statistically significant (t values were -3.104 and -6.912, P <0.01). Multivariate logistic regression analysis showed that high-density lipoprotein cholesterol was the protective factor of lowering CVHI score, age, history of hypertension, history of diabetes, overweight or obesity, left ventricular hypertrophy, history of atrial fibrillation, triglyceride level and male As the risk factors, the OR and 95% CI were 0.774 (0.598-1.002), 1.075 (1.064-1.088), 2.172 (1.871-2.521), 2.044 (1.625-2.571), 1.684 (1.516-1.870) and 2.057 1.593 ~ 2.657), 2.051 (1.080 ~ 3.894), 1.179 (1.092 ~ 1.273) and 1.543 (1.326 ~ 1.796). Conclusions High triglyceride level and high density lipoprotein levels are closely related to impaired cerebrovascular function, which may be an independent influencing factor of cerebrovascular dysfunction.