Sato Shinichi, Iso Hiroyasu, Noda Hiroyuki, Kitamura Akihiko, Imano Hironori, Kiyama Masahiko, Ohira Tetsuya, Okada Takeo, Yao Masayuki, Tanigawa Takeshi, Yamagishi Kazumasa, Nakamura Masakazu, Naito Yoshihiko, Shimamoto Takashi
Osaka Medical Center for Health Science and Promotion, 1-3-2 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.
Stroke. 2006 Oct;37(10):2488-92. doi: 10.1161/01.STR.0000242473.13884.8e. Epub 2006 Aug 31.
We aimed to examine the impact of fibrinogen concentrations on the incidence of stroke.
We examined the association between fibrinogen and risk of total stroke and stroke subtypes in an 11-year prospective study of 4608 men and 7589 women aged 40 to 79 years with no history of stroke and/or coronary heart disease. The analysis was repeated, stratified by smoking status, to examine whether the association between fibrinogen and stroke was modified by smoking.
There were 317 incident total strokes comprising 103 hemorrhagic strokes (70 intraparenchymal hemorrhages [22.1% of strokes], 33 subarachnoid hemorrhages [10.4%]), 206 ischemic strokes (65.0%), and 8 strokes of undetermined type (2.5%). The multivariable hazard ratio (95% CI) for the highest versus lowest fibrinogen quartiles after adjustment for age, sex, area, and known cardiovascular risk factors was 2.5 (1.3 to 5.0), P<0.01, for hemorrhagic stroke and 3.2 (1.4 to 7.4), P<0.01, for intraparenchymal hemorrhage. There was no positive association of fibrinogen with risk of ischemic stroke or subarachnoid hemorrhage. Among never-smokers, the multivariable hazard ratio (95% CI) for the highest versus lowest fibrinogen quartiles was 3.5 (1.3 to 9.3), P=0.01, for hemorrhagic stroke and 4.4 (1.3 to 15.2), P=0.02, for intraparenchymal hemorrhage.
High plasma fibrinogen concentration can be a predictor for risk of intraparenchymal hemorrhage.
我们旨在研究纤维蛋白原浓度对中风发病率的影响。
在一项针对4608名男性和7589名年龄在40至79岁之间、无中风和/或冠心病病史的人群进行的11年前瞻性研究中，我们研究了纤维蛋白原与全中风风险及中风亚型之间的关联。分析按吸烟状况分层重复进行，以研究吸烟是否会改变纤维蛋白原与中风之间的关联。
共有317例新发全中风病例，包括103例出血性中风（70例脑实质内出血[占中风病例的22.1%]，33例蛛网膜下腔出血[10.4%]）、206例缺血性中风（65.0%）和8例类型不明的中风（2.5%）。在调整年龄、性别、地区和已知心血管危险因素后，纤维蛋白原最高四分位数与最低四分位数相比，出血性中风的多变量风险比（95%CI）为2.5（1.3至5.0），P<0.01；脑实质内出血为3.2（1.4至7.4），P<0.01。纤维蛋白原与缺血性中风或蛛网膜下腔出血风险无正相关。在从不吸烟者中，纤维蛋白原最高四分位数与最低四分位数相比，出血性中风的多变量风险比（95%CI）为3.5（1.3至9.3），P=0.01；脑实质内出血为4.4（1.3至15.2），P=0.02。
高血浆纤维蛋白原浓度可能是脑实质内出血风险的一个预测指标。
