CVHI积分和血压水平与脑卒中发病关系

Association of stroke incidence with cerebral vascular hemodynamics index and blood pressure

目的 了解脑血管血液动力学积分（CVHI）和血压水平与脑卒中发病的关系，为脑卒中的预防控制提供参考依据。方法 采用队列研究方法，整群抽取上海市奉贤区某镇10 565名〉40岁常住居民进行问卷调查、CVHI检测和血压测量，并按CVHI积分情况和血压水平进行分组，比较不同CVHI积分组、血压组人群脑卒中的发病风险。结果 上海市奉贤区某镇调查的10 565名〉40岁常住居民中，发生脑卒中（脑出血＋脑梗死）者191例，发病率为1.81%；CVHI积分≥75、50~74、25~49、0~24分组居民脑卒中的发病率分别为0.68%、2.46%、5.25%、8.22%，脑卒中的发病率随CVHI积分的降低呈升高趋势（χ趋势2=271.155，P〈0.001）；对照组、高压病史组、Ⅰ期高血压组、Ⅱ期高血压组、Ⅲ期高血压组居民脑卒中的发病率分别为0.98%、2.52%、2.79%、6.42%、3.30%，脑卒中的发病率随血压水平的增高呈升高趋势（χ趋势2=74.432，P〈0.001）。结论 脑卒中发病风险随着CVHI积分的降低和血压水平的增高而升高。

Objective To study the association of stroke incidence with cerebral vascular hemodynamics index （CVHI）and blood pressure level and to provide reference for the prevention and control of stroke.Methods CVHI dettermination and blood pressure measurement were conducted among 10 565 participants aged 40 years and over selected with cluster sampling from a town in Fengxian county of Shanghai city.The participants were grouped according to CVHI and blood pressure level and followed-up from March of 2003 to December of 2010 for the observation and comparison of stroke incidence in each group.Results Among the participants,there were 191 incidences of stroke（including cerebral hemorrhage and cerebral infarction）,with an incidence rate of 1.81% during the follow-up period.The onset risks were 0.68%,2.46%,5.25%,and 8.22% for the participants with CVHI of ≥75,50-74,25-49 and 0-24.The incidence of stroke increased with the decrease of CVHI（χtrend2 =271.155,P〈0.001）.The incidences of stroke for control group,hypertension group,first phase hypertension group,second phase hypertension group,and third phase hypertension group were 0.98%,2.52%,2.79%,6.42%,and 3.30%,respectively,and the incidence of stroke increased with the increment of blood pressure.（χtrend2=271.155,P〈0.001）.Conclusion The incidence of stroke is positively associated with blood pressure and inversely related to CVHI among residents aged more than 40 years.