Huang Jiu-yi, Wang Gui-qing, Shen Feng-ying, Cao Yi-feng, Wang Yan, Guo Zuo, Yang Yong-ju, Fan Shun-ying, Xu Xiao-bin, Feng Chun-hong, Tian Wen-sheng
Shanghai Institute of Cerebral Vascular Disease Prevention and Care, Shanghai 200433, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2003 Feb;24(2):89-93.
To estimate relative risk (RR) of cerebral vascular hemodynamics indexes (CVHI) accumulative score as well as some other risk factors of stroke.
A cohort study was carried out in 25 355 participants aged 35 and over in Northeast of China from 1994 to 2001. In the baseline survey, exposure rates of hypertension, diabetes, family history of stroke and hypertension, etc. were collected and CVHI was examined. CVHI accumulative score was synthesized according to contribution of single index. During the 7-year following up, 228 stroke cases were identified and stroke coming on was defined as the endpoint of observation. Uni-variable and multiple variables analysis were carried out for estimating RR of CVHI and other risk factors of stroke.
Uni-variables analysis indicated that RR (95% confidence interval, CI) of Hypertension, heart diseases, diabetes, family history of hypertension and stroke, overweight or obesity, alcohol intake, cigarette smoking and CVHI < 75 scores were 3.23 (2.48 - 4.20), 2.53 (1.92 - 3.33), 2.38 (1.55 - 3.64), 1.32 (1.02 - 1.72), 1.82 (1.37 - 2.41), 1.62 (1.25 - 2.11), 1.48 (1.07 - 2.04), 1.76 (1.34 - 2.31) and 7.30 (5.43 - 9.80) respectively. Cox regression analysis showed that CVHI below 75 points, family history of stroke, cigarette smoking, heart disease, hypertension, age and sex were the factors being selected in equation. There was a significant dosage response between the decrease of CVHI score and the increase of stroke risk. RR of stroke reached 12.55 when CVHI below 75 points and history of hypertension appeared in the same individuals.
Abnormality of CVHI score seemed to be the most important and independent factor among stroke risk factors. Decrease of CVHI score might serve as a marker of high risk and play important role in stroke, especially coexistence with hypertension.
评估脑血管血液动力学指标（CVHI）累积积分以及其他一些中风危险因素的相对风险（RR）。
1994年至2001年，在中国东北地区对25355名35岁及以上参与者进行了一项队列研究。在基线调查中，收集高血压、糖尿病、中风家族史和高血压家族史等暴露率，并检测CVHI。根据单项指标的贡献合成CVHI累积积分。在7年的随访期间，确定了228例中风病例，并将中风发病定义为观察终点。对CVHI和其他中风危险因素的RR进行单变量和多变量分析。
单变量分析表明，高血压、心脏病、糖尿病、高血压家族史和中风家族史、超重或肥胖、饮酒、吸烟以及CVHI＜75分的RR（95%置信区间，CI）分别为3.23（2.48 - 4.20）、2.53（1.92 - 3.33）、2.38（1.55 - 3.64）、1.32（1.02 - 1.72）、1.82（1.37 - 2.41）、1.62（1.25 - 2.11）、1.48（1.07 - 2.04）、1.76（1.34 - 2.31）和7.30（5.43 - 9.80）。Cox回归分析表明，CVHI低于75分、中风家族史、吸烟、心脏病、高血压、年龄和性别是方程中入选的因素。CVHI积分降低与中风风险增加之间存在显著的剂量反应关系。当CVHI低于75分且高血压病史出现在同一人群中时，中风的RR达到12.55。
CVHI积分异常似乎是中风危险因素中最重要的独立因素。CVHI积分降低可能作为高风险的标志物，在中风中起重要作用，尤其是与高血压并存时。
