上海市普陀区脑卒中后血管性痴呆危险因素的配对病例对照研究

Matched case-control study of risk factors of vascular dementia after stroke in Putuo District of Shanghai

目的:探讨脑卒中后血管性痴呆(VaD)的危险因素,为预防脑卒中后VaD的发生提供科学依据。方法:本研究为病例对照研究,选取2011年1月至2019年1月收治的142例脑卒中后VaD患者,并按性别、年龄为匹配条件,选取142例脑卒中后未出现VaD的患者进行1∶1配对。142对病例中,男性68对,女性74对,平均年龄(82.99±8.71)岁,其中<80岁41对,≥80岁101对。采用多因素条件logistic回归分析包括合并疾病、生化指标、吸烟史、教育水平等因素与VaD的关系。结果:VaD的发病与下列4种因素关系密切:冠心病(OR=2.370,95%CI:1.114~5.042);糖尿病(OR=2.841,95%CI:1.292~6.247);高尿酸血症(OR=2.447,95%CI:1.025~5.840),贫血(OR=2.190,95%CI:1.277~3.757)。结论:脑卒中后应积极防治冠心病,控制血糖,防止血尿酸过高或过低,纠正贫血以降低脑卒中后VaD的发病率。

Objective:To explore the risk factors of vascular dementia(VD) after stroke,so as to provide scientific basis for the prevention of VD after stroke.Methods:This study was a case-control study,and 142 post-stroke VD patients who were admitted from January 2011 to January 2019 were selected,and according to gender and age as matching conditions,142 patients who did not develop VD after stroke were selected for 1:1 matching.Among 142 cases,there were 68 males and 74 females,with an average age of(82.99±8.71) years,among them,41 pairs were < 80 years old and 101 pairs were ≥ 80 years old.Multivariate conditional logistic regression analysis was used to analyze the relationship between VD and combined diseases,biochemical indexes,smoking history,education level and other factors.Results:The incidence of VD is closely related to the following four factors:coronary heart disease(OR=2.370,95%CI:1.114~5.042);diabetes(OR=2.841,95%CI:1.292~6.247);hyperuricemia(OR=2.447,95%CI:1.025~5.840),anemia(OR=2.190,95%CI:1.277~3.757).Conclusion:After stroke,it is necessary to actively prevent and treat coronary heart disease,control blood sugar,prevent excessive or low blood uric acid,and correct anemia to reduce the incidence of VD after stroke.