中国南海石油工人后循环缺血性卒中的相关危险因素分析

Analysis on risk factors of postcirculation ischemic stroke in oilmen in south China sea

目的了解中国南海石油工人后循环缺血性卒中(PCI)的危险因素。方法选取首发PCI且长期工作于中国南海的石油工人患者120例(PCI组)进行调查,并根据TOAST (Trial of Org 10172 in Acute Stroke Treatment)进行分型,同时按照年龄、性别匹配原则,选取同期体检健康者120例作对照(对照组),对比分析后循环缺血性卒中的危险因素。结果PCI组空腹血糖、高半胱氨酸、尿酸水平显著高于对照组(P<0.01);而总胆固醇、三酰甘油、低密度脂蛋白和高密度脂蛋白水平与对照组比较差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,尿酸、高血压病史和高半胱氨酸水平是PCI的独立危险因素(P<0.01);男性、尿酸及高血压病史是动脉粥样硬化性大血管病变的独立危险因素(P<0.05或0.01);高血压病史、糖尿病史是小血管病变的独立危险因素(P<0.05);女性、高血压病史是心源性栓塞的独立危险因素(P<0.05或0.01)。结论影响中国南海石油工人PCI的危险因素较多且典型,调整该人群的饮食结构对其预防起着重要的作用。

Objective To explore the risk factors of postcirculation ischemic stroke(PCI)in oilmen in south China sea.Methods A total of 120 oilmen(PCI Group)that had the first attack of PCI and had been long working in south China sea have been investigated and classified according to the Trial of Org 10172 in Acute Stroke Treatment(TOAST).Meanwhile,according to the age and gender matching principles,120 case of healthy worker at the same period were selected as control(Control Group).The risk factors of postcirculation ischemic stroke were compared and analyzed.Results PCI Group had the fasting blood-glucose,homocysteine and uric acid level significantly higher than the Control Group(P<0.01);there was no statistical difference in total cholesterol,triglycerides,LDL and HDL levels between the two groups(P>0.05).Multiple logistic regression showed that uric acid,history of hypertension,and homocysteine level are the independent risk factors of PCI(P<0.01);Male,uric acid and history of hypertension were independent risk factors for artherosclerosi large artery disease(P<0.05 or 0.01);History of hypertension and history of diabetes were an independent risk factor for small artery disease(P<0.05);Women and history of hypertension were independent risk factors for cardiogenic embolism(P<0.05 or 0.01).Conclusion There are quite a lot risks factors that affect the PCI of oilmen in south China sea.Adjusting dietary structure may have a positive significance for the prevention of PCI in oilmen in South China Sea.