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目的探讨卒中预防策略实施过程中影响卒中发病的主要因素。方法在干预队列人群中,采取12病例-对照研究方法,选择随访期间(1999~2001年)发生卒中的患者402例为病例组,选取未发生卒中的高危患者804例为对照组。比较病例和对照组间脑血管血液动力学指标(CVHI)的差异,对研究因素进行单因素和多因素Logistic回归分析。结果病例组与对照组的CVHI积分均值分别为(31.85±20.01)分和(40.41±18.99)分(P<0.001),且与卒中发病具有显著的剂量反应关系。单因素分析显示,高血压病是卒中发病的危险因素,服用重点干预药物是保护因素,其优势比OR(95%CI)分别为2.43(1.25,4.84)和0.43(0.33,0.55)。多因素Logistic回归分析显示,被筛选进入回归方程的因素依然是高血压病史、服用重点干预药物和CVHI积分筛检。结论影响卒中发病的主要危险因素是高血压病和CVHI积分降低的程度,服用重点干预药物可显著降低卒中发病风险。
Objective To explore the main factors influencing the incidence of stroke during the implementation of stroke prevention strategy. Methods In a cohort cohort, 402 case-control studies were conducted. A total of 402 patients with stroke during the follow-up period (1999-2001) were selected as the case group. A total of 804 high-risk patients without stroke were selected as control group. The difference of cerebrovascular hemodynamic parameters (CVHI) between the cases and the control group was compared, and the study factors were analyzed by single factor and multivariate Logistic regression. Results The mean CVHI scores of case group and control group were (31.85 ± 20.01) and (40.41 ± 18.99) points respectively (P <0.001), and had significant dose response relationship with stroke. Univariate analysis showed that hypertension was the risk factor of stroke. Taking key intervention drugs as the protective factor, odds ratio (95% CI) were 2.43 (1.25, 4.84) and 0.43 (0.33, 0.55) respectively. Multivariate Logistic regression analysis showed that the factors screened into the regression equation were still history of hypertension, key interventions and CVHI score screening. Conclusions The main risk factors affecting the incidence of stroke are the reduction of hypertension and CVHI. The use of key intervention drugs can significantly reduce the risk of stroke.