脑梗塞遗传因素Logistic回归及通径分析

Conditional logistic regression analysis and path analysis of genetic factors on cerebral infarction

目的 探索遗传因素在脑梗塞发病过程中的作用。方法 对张家口医学院第一、第二附属医院神经内科住院的脑梗塞新发病例共 112例 ,以同期住院的非心脑血管病人为对照 ,采用 1∶1配对设计 ,并进行问卷调查了解家系亲属中脑梗塞的发病情况。进行单因素及多因素的条件Logistic回归分析、通径分析。 结果 父亲患病年龄、母亲患病年龄、同胞患病及二级亲属患病与脑梗塞的发病呈显著正相关 ,但通径分析结果剩余变异较大 ,解释力仅2 6 %。结论 遗传因素在脑梗塞的发病过程中起着一定的作用 ,但通过通径分析综合研究认为 :遗传因素只是脑梗塞发病危险因素中的一个方面 ,其解释力仅为 2 6 % ,故认为环境因素 ,特别是个体本身所具备的某些特征对脑梗塞发病的作用更大。

Objective To explore the relationship between genetic factors and the development of cerebral infarction.Methods One hundred and twelve cases who were primary patients of cerebral infarction in the neurology department of the first and the second affiliated hosital of Zhangjiakou Medical College were selected.One hundred and twelve controls who were patients of no cerebral infarction in same hospital during the same period were selected by the 1∶1 matched case-control study.One-way and multivariate conditional logistic regression analysis and path analysis were used to affirm the risk factors of cerebral infarction.Results The incidence age of father and mother,the prevalence of siblings and second-degree relatives had positive relationship with cerebral infaction.The results of path analysis indicated that the residual variation was on the high side,and the ability of explanation was only 26%.Conclusion Genetic factor played a role to some extent in the incidence of infarction.The study of path analysis showed that the genetic factor was only one of risk factors,the ability of explanation was only 26%,therefore,the environment factor was more important than other factors.