Pan W H, Bai C H, Chen J R, Chiu H C
Division of Epidemiology and Public Health, Academia Sinica, Taipei, Taiwan, ROC.
Stroke. 1997 Jan;28(1):88-94. doi: 10.1161/01.str.28.1.88.
A subsample of 147 Chinese subjects from a population-based study of cardiovascular diseases (Cardiovascular Disease Risk Factor Two-Township Study) participated in an ancillary study on extracranial carotid color duplex ultrasonography that aimed to assess the relations of coagulation factors to stroke and carotid atherosclerosis.
Logistic models were used to study the associations between cardiovascular disease risk factors and stroke/carotid atherosclerosis, controlling for the effects of age and sex.
Stroke was significantly associated with hypertension and high values of plasma glucose but not with fibrinogen, factor VIIc, or factor VIIIc. Carotid plaques identified in this study were mostly mild and moderate. The presence of these mild and moderate carotid plaques was significantly associated with high values of factor VIII activity, hypercholesterolemia, hypertriglyceridemia, and hypertension. The highest tertile of factor VIIIc (> 1.53) was associated with an odds ratio of 3.35 for carotid atherosclerosis when compared with the lowest tertile (< 1.20). A multiple logistic regression including all significant risk factors showed that the degree of association between factor VIIIc and atherosclerosis was attenuated to an odds ratio of 2.65 (P = .061).
In the present study, the roles of hypertension, hypercholesterolemia, and hypertriglyceridemia have been implicated in the pathogenesis of carotid atherosclerosis, and roles for hypertension and hyperglycemia in stroke were indicated. A positive association between factor VIIIc and carotid atherosclerosis in this Chinese population was found. Whether this association is independent of the effect of other cardiovascular risk factors awaits further study.
在一项基于人群的心血管疾病研究（心血管疾病危险因素双乡镇研究）中，抽取了147名中国受试者作为子样本，参与一项关于颅外颈动脉彩色双功超声的辅助研究，该研究旨在评估凝血因子与中风及颈动脉粥样硬化之间的关系。
采用逻辑模型研究心血管疾病危险因素与中风/颈动脉粥样硬化之间的关联，并对年龄和性别的影响进行控制。
中风与高血压和高血糖水平显著相关，但与纤维蛋白原、因子VIIc或因子VIIIc无关。本研究中识别出的颈动脉斑块大多为轻度和中度。这些轻度和中度颈动脉斑块的存在与因子VIII活性升高、高胆固醇血症、高甘油三酯血症和高血压显著相关。与最低三分位数（<1.20）相比，因子VIIIc的最高三分位数（>1.53）与颈动脉粥样硬化的比值比为3.35。一项纳入所有显著危险因素的多元逻辑回归显示，因子VIIIc与动脉粥样硬化之间的关联程度减弱至比值比为2.65（P = 0.061）。
在本研究中，高血压、高胆固醇血症和高甘油三酯血症在颈动脉粥样硬化的发病机制中具有重要作用，同时表明高血压和高血糖在中风中也起作用。在中国人群中发现因子VIIIc与颈动脉粥样硬化呈正相关。这种关联是否独立于其他心血管危险因素的影响有待进一步研究。
