汇集队列风险方程在健康体检者脑卒中风险预测中的应用

Application of pooled cohort risk equations in predicting the risk of stroke among physical examiners

目的比较汇集队列风险方程(PCE)和改良Framingham卒中风险评估量表(R-FSP)在健康体检人群卒中风险评估中的应用效果,为预防人群卒中提供指导依据。方法 2017年1～12月随机抽取于宜宾市第二人民医院健康管理中心体检的40～70岁健康体检者1 277名,采用R-FSP和PCE评估其10年卒中风险,比较M-FSP和PCE在卒中风险评估应用中的一致性。结果采用R-FSP和PCE评估1 277名健康体检者的10年卒中风险概率分别为5.8%和6.1%。R-FSP预测卒中风险男性(6.0%)高于女性(5.5%),PCE预测结果也一致(男vs女:6.5%vs 5.7%),R-FSP预测BMI≥24 kg/m2者卒中风险(6.5%)高于BMI<24 kg/m2(5.5%),PCE预测结果也一致(≥24 kg/m2vs <24 kg/m2:6.8%vs 5.9%);R-FSP预测40～50岁、50～60岁和60～70岁年龄段体检者卒中风险概率分别为3.6%、5.9%和9.2%,PCE预测结果分别为4.0%、6.0%、9.9%,差异均有统计学意义(P<0.05);R-FSP和PCE评估卒中风险结果有高度一致性,其Pearson相关系数和组内相关系数(ICC)分别为0.719和0.757 (P<0.05)。结论 R-FSP和PCE均能较好地预测卒中发生风险概率,研究者可以根据实际情况选择合适的预测工具。

Objective To compare the applications of pooled cohort risk equations (PCE)and revised Framingham stroke risk profile (R-FSP)in predicting the risk of stroke among physical examiners,and to provide effective strategy for preventing stroke.Methods From January 2017 to December 2017,1277 physical examiners were selected randomly from No.2 Peoples' Hospital of Yibin to assess their 10 years stroke risk by R-FSP and PCE,and the consistency of R-FSP and PCE in stroke risk assessment was compared.Results The probability of stroke predicted by R-FSP and PCE was 5.8% and 6.1%respectively among 1277 physical examiners,with male (6.0%) higher than female (5.5%) by R-FSP,and the same tendency predicted by PCE (male vs female:6.5% vs 5.7%);the probability of stroke predicted byR-FSP for the patients with BMI≥24kg/m2(6.5%) was higher than BMI<24kg/m^2(5.5%),with the same tendency predicted by PCE (≥24kg/m^2 vs <24kg/m^2:6.8%vs 5.9%).The probability of stroke predicted by R-FSP for 40-50 years old,50-60years old and 60-70 years old were respectively 3.6%,5.9%,9.2%versus corresponding 4.0%,6.0%,9.9% predicted by PCE (all P<0.05).The results of stroke risk predicted by R-FSP and PCE was high consistency with Pearson correlation coefficient (0.719) and intraclass correlation coefficient (0.757),P<0.05.Conclusion R-FSP and PCE are suited to predict the probability of stroke with high consistency,and researchers could select appropriate prediction tools according to distinctive situation.