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目的探讨理想心血管健康行为和因素对新发缺血性脑卒中的影响。方法采用前瞻性队列研究方法,以参加2006-07-2007-10开滦集团健康查体的职工为研究对象,排除既往患脑梗死、心肌梗死及与该研究有关的数据和资料不全者,最终91698名职工进入观察队列,观察随访该队列发生新发缺血性脑卒中的情况;依据美国心脏协会定义的理想心血管健康行为和因素,用K-M法计算不同理想心血管健康行为和因素组的缺血性脑卒中累积发病率,并经Log-rank检验;采用Cox比例风险模型分缺血性脑卒中的影响因素。结果具备5～7项理想心血管健康行为和因素的个体只占研究人群的9.1%,其中具备所有7项的只有93例,占研究人群的0.1%,不足4项者占69.4%。具有0～1、2、3、4、5～7项理想心血管健康行为和因素的人群缺血性脑卒中的累积发病率逐渐降低(P<0.01);Cox比例风险模型表明,校正性别、年龄、收入水平、受教育水平后,具备1～6项理想心血管健康行为和因素的人群发生缺血性脑卒中的风险为无健康行为和因素人群的0.99、0.71、0.51、0.35、0.24、0.28倍。结论理想心血管健康行为和因素对脑血管具有保护作用,随着理想心血管健康行为和因素的个数增多,缺血性脑卒中的累积发病率呈下降趋势。
Objective To investigate the effect of ideal cardiovascular health behaviors and factors on new-onset ischemic stroke. Methods A prospective cohort study was conducted with the participation of workers in Kailuan Group for physical examination from July 2006 to October 2007 with the aim of excluding patients with previous cerebral infarction and myocardial infarction as well as incomplete data and information related to the study. A total of 91,698 employees entered the observation cohort and observed the occurrence of new ischemic stroke in this cohort. According to the ideal cardiovascular health behaviors and factors defined by the American Heart Association, the KM method was used to calculate the optimal cardiovascular health behaviors and factors The cumulative incidence of ischemic stroke, and by Log-rank test; using Cox proportional hazards model of ischemic stroke risk factors. Results Individuals with 5 to 7 ideal cardiovascular health behaviors and factors accounted for only 9.1% of the study population, of whom 93 had all 7, accounting for 0.1% of the study population and 69.4% of those less than 4. The cumulative incidence of ischemic stroke among 0 ~ 1, 2, 3, 4, 5 ~ 7 ideal cardiovascular health behaviors and factors gradually decreased (P <0.01). Cox proportional hazards model showed that the adjusted gender, Age, income level, education level, with 1-6 ideal cardiovascular health behaviors and factors in people with ischemic stroke risk for unhealthy behavior and factors in the population 0.99,0.71,0.51,0.35,0.24, 0.28 times. Conclusions Ideal cardiovascular health behaviors and factors have a protective effect on cerebrovascular. As the number of ideal cardiovascular health behaviors and factors increases, the cumulative incidence of ischemic stroke shows a decreasing trend.