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目的研究不同血清总胆红素水平与新发脑梗死事件的关系。方法采用队列研究方法,以参加2006年7月至2007年10月健康查体的开滦集团在职及离退休职工90 532人作为观察队列。研究人群按血清总胆红素四分位水平(1.0~9.7,9.8~12.2,12.3~15.1,15.2~40.0μmol/L)分组,随访38~53月,随访期间每半年收集1次新发脑梗死事件情况。用多因素Cox比例风险回归模型分析四组血清总胆红素水平对新发脑梗死事件的影响。结果随访期间共发生1106例脑梗死事件,血清总胆红素四分位分组总的脑梗死事件累积发病率分别为1.52%、1.21%、1.38%、1.70%(P<0.05)。Cox分析校正其他传统危险因素后,与第2分位组比较,第1分位组发生脑梗死事件的HR为1.21(95%CI1.02~1.44)。结论血清总胆红素在1.0~9.7μmol/L为新发脑梗死事件的独立危险因素。
Objective To study the relationship between different serum total bilirubin levels and new-onset cerebral infarction. Methods A cohort study was conducted with a cohort of 90,532 active and retired workers in Kailuan Group, who participated in the physical examination from July 2006 to October 2007. The study population was divided into four groups according to the level of serum total bilirubin (1.0-9.7, 9.8-12.2, 12.3-15.1, 15.2-40.0μmol / L). The patients were followed up for 38-59 months. Infarction situation. The effect of serum total bilirubin level on the incidence of new-onset cerebral infarction was analyzed by multivariate Cox proportional hazards regression model. Results A total of 1106 cerebral infarction events occurred during the follow-up period. The cumulative incidence of total cerebral infarction in the total bilirubin quartile group was 1.52%, 1.21%, 1.38% and 1.70%, respectively (P <0.05). After adjusting for other traditional risk factors by Cox analysis, HR for first-episode cerebral infarction was 1.21 (95% CI, 1.02 to 1.44) compared with the second. Conclusion Serum total bilirubin is an independent risk factor for new-onset cerebral infarction in the range of 1.0-9.7 μmol / L.