中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2010年
3期
268-271
,共4页
江滨%方向华%刘运海%戴秀英%林志国%苏芳忠%杨期东%王文志%吴升平%李世绰
江濱%方嚮華%劉運海%戴秀英%林誌國%囌芳忠%楊期東%王文誌%吳升平%李世綽
강빈%방향화%류운해%대수영%림지국%소방충%양기동%왕문지%오승평%리세작
脑血管意外%胆固醇%高甘油三酯%前瞻性研究
腦血管意外%膽固醇%高甘油三酯%前瞻性研究
뇌혈관의외%담고순%고감유삼지%전첨성연구
Cerebrovascular accident%Cholesterol%Hypertriglyceridemia%Prospective study
目的 研究人群总胆固醇(TC)、甘油三酯(TG)水平与缺血性和出血性卒中发病的关系.方法 1987年5至7月,对在北京等5个城市社区所选取的35岁以上无卒中队列人群进行卒中危险因素调查和体格检查,1998至2000年对入选的队列人群进行全面复查,共10093例完成基线血脂调查及队列随访.采用Cox回归模型估计基线TC和TG中、高三分位组缺血性与出血性卒中发病的相对危险度(风险比,HR)和95%可信区间(95%CI).结果 平均随访8年,新发卒中491例.舒张压模型调整舒张压、年龄和性别等多因素后,与低TC组相比,中、高TC组缺血性卒中发病风险分别增加61%(HR:1.61,95% CI:1.14～2.27)和58%(HR:1.58,95%CI:1.12～2.22).与低TG组相比,高TG组缺血性卒中发病风险增加43%(HR:1.43,95%CI:1.02～2.00).TC与出血性卒中呈负相关,与低TC组相比,中、高TC组人群出血性卒中发病的危险分别减少了12%(HR:0.88,95%CI:0.64～1.22)和33%(HR:0.67,95%CI:0.48～0.95).结论 血清TC和TG升高均为缺血性卒中发病独立危险因素.但TC过低却增加出血性卒中的发病风险.
目的 研究人群總膽固醇(TC)、甘油三酯(TG)水平與缺血性和齣血性卒中髮病的關繫.方法 1987年5至7月,對在北京等5箇城市社區所選取的35歲以上無卒中隊列人群進行卒中危險因素調查和體格檢查,1998至2000年對入選的隊列人群進行全麵複查,共10093例完成基線血脂調查及隊列隨訪.採用Cox迴歸模型估計基線TC和TG中、高三分位組缺血性與齣血性卒中髮病的相對危險度(風險比,HR)和95%可信區間(95%CI).結果 平均隨訪8年,新髮卒中491例.舒張壓模型調整舒張壓、年齡和性彆等多因素後,與低TC組相比,中、高TC組缺血性卒中髮病風險分彆增加61%(HR:1.61,95% CI:1.14～2.27)和58%(HR:1.58,95%CI:1.12～2.22).與低TG組相比,高TG組缺血性卒中髮病風險增加43%(HR:1.43,95%CI:1.02～2.00).TC與齣血性卒中呈負相關,與低TC組相比,中、高TC組人群齣血性卒中髮病的危險分彆減少瞭12%(HR:0.88,95%CI:0.64～1.22)和33%(HR:0.67,95%CI:0.48～0.95).結論 血清TC和TG升高均為缺血性卒中髮病獨立危險因素.但TC過低卻增加齣血性卒中的髮病風險.
목적 연구인군총담고순(TC)、감유삼지(TG)수평여결혈성화출혈성졸중발병적관계.방법 1987년5지7월,대재북경등5개성시사구소선취적35세이상무졸중대렬인군진행졸중위험인소조사화체격검사,1998지2000년대입선적대렬인군진행전면복사,공10093례완성기선혈지조사급대렬수방.채용Cox회귀모형고계기선TC화TG중、고삼분위조결혈성여출혈성졸중발병적상대위험도(풍험비,HR)화95%가신구간(95%CI).결과 평균수방8년,신발졸중491례.서장압모형조정서장압、년령화성별등다인소후,여저TC조상비,중、고TC조결혈성졸중발병풍험분별증가61%(HR:1.61,95% CI:1.14～2.27)화58%(HR:1.58,95%CI:1.12～2.22).여저TG조상비,고TG조결혈성졸중발병풍험증가43%(HR:1.43,95%CI:1.02～2.00).TC여출혈성졸중정부상관,여저TC조상비,중、고TC조인군출혈성졸중발병적위험분별감소료12%(HR:0.88,95%CI:0.64～1.22)화33%(HR:0.67,95%CI:0.48～0.95).결론 혈청TC화TG승고균위결혈성졸중발병독립위험인소.단TC과저각증가출혈성졸중적발병풍험.
Objective To explore associations between levels of total cholesterol (TC), triglyceride (TG) and incidence of ischemic and hemorrhagic strokes in populations. Methods Baseline investigations on stroke-related risk factors and physical examinations were performed in 10 093 ( > 35 years) stroke-free urban community residents from 5 cities in China during May to July in 1987, follow-up investigations on stroke events were made during 1998 to 2000. The hazard ratios and 95% confidence intervals (CI) of iachemic and hemorrhagic strokes in middle, high tertiles of baseline TC or TG levels were compared with low baseline tertile residents using the Cox regression model. Results There were 491 first strokes during the 8-years cohort follow-up. Compared with the low tertile, risk of ischemic stroke in the middle and high tertiles of TC level was increased by 61% ( HR: 1.61,95% CI: 1.14 -2. 27) and 58% (HR: 1.58, 95% CI: 1.12 -2. 22) after adjustments for DBP, age, sex and other variables in the Cox proportional hazards model. Compared with the low tertile, risk of ischeroic stroke in the high tertile of TG level was increased by 43% (HR: 1.43, 95% CI: 1.02 -2.00). However, risk of hemorrhagic stroke in the middle and high tertiles of TC level decreased by 12% (HR: 0.88, 95% CI: 0.64-1.22) and 33% (HR: 0.67, 95% CI:0. 48 - 0. 95) compared with the low tertile. Conclusions Elevated serum TC and TG are independent risk factors for risk of ischemie stroke. However, low TC was related with increased risk of hemorrhagic stroke.
