阜新农村地区高血压人群非高密度脂蛋白胆固醇水平与脑卒中发病的关系

Relationship Between Non High Density Lipoprotein Cholesterol and Stroke in Hypertensive Population in Rural Areas of Fuxin

目的了解阜新农村地区高血压人群的血脂分布状况,探讨高血压人群非高密度脂蛋白胆固醇（NonHDLC）水平和脑卒中发生的关系。方法 2004~2006年,于辽宁省阜新县农村地区采用多级整群抽样方法调查受访人群的血脂水平,2014年进行回访,最终纳入研究对象4 915人,按其Non-HDLC总体水平按四分位法分组,4组分别为：〈3.25 mmol/L组、3.25~mmol/L组、3.78~mmol/L组、4.33~mmol/L组,探讨Non-HDLC水平与脑卒中发病的关系。结果随着non-HDLC水平升高,总体脑卒中及缺血性脑卒中的发病率逐渐增加,而出血性脑卒中的发病率呈短暂上升后又呈一定下降。与〈3.25 mmol/L组比较,4.33~mmol/L组发生总体脑卒中[RR=1.39（1.11~1.75）,P=0.004]及缺血性脑卒中[RR=1.75（1.32~2.32）,P〈0.001]的风险明显升高;其他两组与〈3.25 mmol/L组比较,发生总体脑卒中及缺血性脑卒中的风险无统计学差异。而出血性脑卒中的相对危险度与non-HDLC水平无明显相关。结论 non-HDLC水平升高与高血压人群发生总体脑卒中及缺血性脑卒相关,而与出血性脑卒中无明显联系。应加强农村地区高血压人群的血脂水平监测和控制,以减少相关心脑血管疾病的发生。

Aim To study the distribution of blood lipid in hypertensive population and to explore the clinical applications of non-HDLC（non high density lipoprotein cholesterol） in evaluating the occurrence of stroke.Methods A multistage,stratified clustering sampling scheme was conducted from 2004 to 2006 in the rural areas of Fuxin County,Liaoning Province to investigate the blood lipid level of interviewees who were supposed to be followed up in 2014.4 915 interviewees were available eventually.The levels of non-HDLC were divided into 4 groups： 3.25 mmol/L,3.25 ~mmol/L,3.78 ~ mmol/L,4.33 ~ mmol/L to research the relationship between non-HDLC and stroke according to the quartile division of non-HDLC.Results With the increasing of the level of non-HDLC,the crude incidences of total stroke and ischemic stroke went up in accordance while the crude incidence of hemorrhagic stroke increased for a bit and then decreased apparently.Comparing with the group of 3.25 mmol/L,the risks of total stroke [RR = 1.39（1.11 ~ 1.75）,P =0.004]and ischemic stroke [RR = 1.75（1.32 ~ 2.32）,P0.001]were high and meaningful statistically when non-HDLC≥4.33 mmol/L and meaningless statistically.Comparing with the group of 3.25 mmol/L,when non-HDLC 4.33 mmol/L,the relationship of relative risk between hemorrhagic stroke and the level of non-HDLC was not clear.Conclusions The increasing level of non-HDLC was related to total stroke and ischemic stroke and unrelated to hemorrhagic stroke in hypertensive population.The lipid level of rual hypertensive population should be monitored and controlled intensively to decrease the occurance of correlative cardiovascular diseases.