卒中危险因素与脑血管血液动力学因素的交互作用

A Study on Interaction between Risk Factors of Stroke and Cerebrovascular Hemodynamics

目的探讨卒中主要危险因素与脑血管血液动力学因素间的交互作用。方法对24475例35岁以上人群的基线调查、脑血管血液动力学指标(CVHI)检测结果及卒中发病随访资料进行分析,计算各危险因素单独暴露和CVH I积分异常联合对卒中发生的相对危险度(RR),分析两者间的交互作用。结果高血压病史、心脏病史、糖尿病史、卒中家族史、高血压病家族史等卒中危险因素暴露者伴有CVH I积分值降低时,调整RR分别为9.40(95%CI6.20～14.23),7.61(95%CI4.85～11.94),6.95(95%CI3.98～12.13),8.74(95%CI5.49～13.89),7.14(95%CI4.41～11.57),明显高于两者单独暴露的RR,呈相加模型的协同作用。结论有高血压病、心脏病、糖尿病病史,卒中和高血压病家族史者CVH I积分值降低时,卒中的风险明显升高,两者呈协同作用。

Objective To probe into interactions between major risk factors of stroke and cerebrovascular hemodynamics. Methods Data of baseline investigation, detection of cerebrovascular hemodynamic indexes （CVHI）, and follow up of stroke incidence in a cohort study with 24 475 individuals were collected. Relative risk （RR） of risk factors for stroke both in independent exposure or combined with abnormal CVHI score were estimated. Interactions between risk factors of stroke and CVHI score were analyzed. Results When exposure to risk factors for stroke, such as history of hypertension, heart disease, diabetes, family history of stroke, family history of hypertension, the adjusted RRs for stroke in stroke patients combined with decreasing CVHIs score were 9.40（6.20± 14.23）, 7.61（4.85± 11.94）, 6.95（3.98± 12.13）, 8.74（5.49± 13.89） and 7.14（4.41 ± 11.57）, respectively. The CVHIs score was significantly higher than that in normal range. The synergetic model of these factors and CVHI score was additive. Conclusion Risks of stroke were significantly increased in the individuals with both risk factors of stroke and abnormal CVHI score. They were playing a synergetic role.