155例干预过程中发生卒中影响因素分析

A Nested Case-Control Study of Factors for Occurrence of Stroke in 155 Patients With Stroke During Intervention

目的分析干预过程中未能有效防止卒中发病的原因 ,为提高预防效果提供依据。方法用巢式病例对照研究设计 ,选择上海市南汇区 6镇卒中高危人群筛检及综合干预过程中新发生的卒中 15 5例为病例组 ,以 1∶ 2的比例在参加脑血管血液动力学指标 (cerebral vascular hemodynamic indexes,CVHI)筛检并干预但未发生卒中的人群中按年龄、性别、CVHI总积分异常的比例随机选取 310例为对照组 ,计算各危险因素、高血压治疗、服重点干预药“脑安胶囊”等因素的优势比 (OR) ,进行多因素分析。结果单因素分析显示 :高血压、心脏病、重点干预药与卒中发病具有显著意义的统计学联系 ,其 OR值分别为 1.92 (1.2 1～ 3.5 0 ) ,1.81(1.0 0～ 3.30 )和 0 .6 3(0 .4 1～ 0 .94 )。多因素 logistic回归分析显示 ,被筛选进入方程的因素分别是高血压病史和服重点干预药 ,控制高血压治疗因素后 ,被筛选进入方程的因素只有服重点干预药。结论综合干预过程中 ,发生卒中的主要原因是有高血压病史和没有按规定服用重点干预药。

Objective To analyze factors for stroke in patients occurred during intervention and provide evidence for enhancing effectiveness of prevention.Methods A nested case-control study was conducted.Case group was 155 stroke patients occurred during intervention in six towns of Nanhui county of Shanghai city from 1999 to 2001,and 310 controls was non-stroke individuals randomly selected from the same intervention cohort according to age,gender and cerebral vascular hemodynamic indexes(CVHI) accumulative score.Odds ratio(OR) and 95% confidence interval(CI) of related factors were estimated both in univariate and multivariate methods.Results Univariate analysis indicated that history of hypertension and heart disease were risk factors for stroke occurrence,while,taking Chinese medicine named 'Naoan Capsule' was protective factor with OR 1 92(1 21~3 50),1 81(1 00～3 30) and 0 63(0 41～0 94),respectively.Logistic regression analysis showed that history of hypertension and taking Naoan capsule were the factors being selected into equation.When hypertension therapy was controlled,taking 'naoan capsule' was the only factor being selected into equation.Conclusion During intervention,main risk factors for stroke is history of hypertension,and no taken Naoan capsule as required.