脑卒中危险因素对脑血管功能影响

Impact of risk factors for stroke on cerebrovascular function among physical examinees:a hospital-based survey

目的了解脑卒中危险因素对脑血管功能的影响,为脑卒中的预防控制提供参考依据。方法整群抽取2016年10月—2021年7月在湖北省武汉市黄陂区人民医院就诊并使用脑血管功能检测仪进行脑卒中筛查的85532名年龄≥20岁健康体检人员及患者进行问卷调查和体格检查,应用多因素非条件logistic回归分析脑卒中危险因素对脑血管功能积分(脑功分)的影响。结果最终纳入分析的83742名健康体检人员及患者的脑功分为1~100分,平均脑功分为(74.98±23.30)分;其中,脑功分<75分的脑卒中高危人群29313例,脑卒中高危率为35.00%。多因素非条件logistic回归分析结果显示,女性、年龄≥45岁、体质指数≥18.5、高血压、糖尿病和心血管疾病均为脑卒中的独立危险因素;年龄较大、体质指数较高、有高血压、糖尿病和心血管病人群的脑功分、平均流速和最小流速的水平均较低,外周阻力和临界压力的水平均较高,而女性的临界压力低于男性。结论脑卒中危险因素与低水平的脑血管功能、平均流速、最小流速和高水平的外周阻力、临界压力相关。

Objective To examine the influence of stroke risk factors on cerebrovascular function in adult outpatient attendees and to provide a reference for the prevention and control of stroke.Methods Questionnaire survey and screening on stroke risk with a cerebrovascular function detector were conducted among 85532 adult outpatient attendees(≥20 years old)recruited using cluster sampling at a hospital in Wuhan city,Hubei province from October 2016 to July 2021.Unconditional multivariate logistic regression analysis was performed to explore the impact of risk factors for stroke on cerebrovascular function(function score).Results Complete information were collected from a total of 83742 participants(41776 males and 41966 females)aged 58.58±13.29 years.For all the participants,the average cerebrovascular function score was 74.98±23.30 in a scale from 1 to 100 and 29313(35.00%)of the participants had a cerebrovascular function score of less than 75,indicating with a high risk of stroke.The results of logistic regression analysis showed that being female,aged≥45 years,with a body mass index(BMI)of≥18.5,suffering from hypertension,diabetes mellitus and cardiovascular disease were independent risk factors for with a high risk of stroke.The cerebrovascular function score,mean cerebral blood flow(CBF)rate and minimum CBF rate were lower but the peripheral resistance and critical pressure of CBF were higher among the participants at older age,with a higher BMI,and having hypertension,diabetes,and cardiovascular disease.The critical pressure of CBF were lower among female participants than that among male participants.Conclusion Being at a high risk of stroke is associated with low cerebrovascular function score,mean and minimum CBF rate,and high CBF peripheral resistance and critical pressure among adult physical examinees.