A型行为与脑梗死及血液流变学的相关性研究

A case-control study on relationship between type A behavior and cerebral infarction and hemorheology

目的 研究A型行为 (TAB)与脑梗死及血液流变学的关系 ,为脑梗死的预防提供依据。方法 采用 1∶1配对病例对照设计 ,应用全国心身医学协作组编制的“A型行为类型问卷”对 2 45例脑梗死患者及 2 45名健康对照进行问卷调查 ;并随机筛选出A型行为脑梗死患者 (TAB组 )和与之相匹配的非A型行为脑梗死患者 (非TAB组 )各 5 0例 ,同时随机选取TAB和非TAB健康人员各 5 0名作为对照组 ,4组受试者均于晨 6时空腹抽静脉血进行血液流变学检测。结果 脑梗死组TAB者占 79.5 % ,对照组TAB者占 5 4.8% ,优势比值为 3.16 (95 %可信限为 2 .0 6～ 4.84,P <0 .0 0 5 )。TAB组患者全血低切粘度 (1s- 1 )、血浆粘度 (10 0s- 1 )、红细胞聚集指数及血浆纤维蛋白原显著高于非TAB组及对照组 (P <0 .0 5 )。结论 A型行为可能是导致脑梗死的危险因素之一 ;对A型行为给与适当的干预 ,应是脑梗死一级预防的内容之一。

Objective To explore the relationship between type A behavior (TAB),cerebral infarction and hemorheology.Methods A case control study was carried out in 245 cerebral infarction patients and 245 healthy people as controls.The investigation was conducted on the basis of 'Type A Behavior Questionnaire'.Fifty cerebral infarction patients with TAB (TAB group) and 50 cerebral infarction patients with non TAB (non TAB group) served as subjects for hemorheological examination.Fasting venous blood samples were taken at 6:00 for hemorheological examination.Results The prevalence of TAB was 79.5% in cerebral infarction group and 54.8% in the control group,with odds ratio of 3.16 (95%CI was 2.06～4.84,P<0.005).The whole blood viscosity at low shear rate (1 s -1 ),plasma viscosity,the red blood cell aggregation index (RAI) and plasma fibrinogen in TAB group were significantly higher than those in non TAB group and control group(P<0.05).Conclusions TAB may be one of the risk factors for ischemic stroke.The interventionist treatment of TAB should be one of the measures for the primary prevention of the ischemic stroke.