天津市834名社区脑卒中高危人群血清同型半胱氨酸水平及相关危险因素分析

Analysis of the serum homocysteine levels and the relevant risk factors of stroke on 834 high-risk community residents in Tianjin

    摘要
  • 摘要:
    目的 了解天津市河北区及东丽区40岁以上脑卒中高危人群危险因素、暴露水平及其人群分布特征, 探讨脑卒中高危人群血清同型半胱氨酸(Hcy)水平及其影响因素。
    方法 纳入脑卒中高危人群834名, 按年龄将其分为A组(40~49岁)、B组(50~59岁)、C组(60~69岁)和D组(≥70岁)。通过方差分析、χ2检验及二元logistic回归分析对数据进行分析。
    结果 A组血清Hcy水平为(12.25±4.54)μmol/L, B组为(14.01±6.67)μmol/L, C组为(15.76±8.88)μmol/L, D组为(18.21±8.99)μmol/L, 随着年龄增长血清Hcy水平也随之升高(F=15.476, P < 0.05)。男性高同型半胱氨酸血症(HHcy)比例高于女性(χ2=31.034, P < 0.05)。既往脑卒中史及吸烟者HHcy比例高于非暴露者(χ2=9.888和18.486, P均 < 0.05);短暂性脑缺血发作、心脏病、高血压、血脂异常及缺乏体育锻炼者HHcy比例与非暴露者比较差异无统计学意义(χ2=0.688、0.773、2.042、1.427和0.560, P均>0.05);而糖尿病者HHcy比例低于非暴露者(χ2=30.345, P < 0.05)。logistic回归分析得到HHcy的独立危险因素包括男性(OR=2.332)、吸烟(OR=1.537)及既往脑卒中史(OR=1.946)。
    结论 血清Hcy检测在脑卒中高危人群筛查中有重要价值, HHcy是脑卒中的独立危险因素之一。应对脑卒中高危人群进行科学的指导干预以降低脑卒中的发生率。

     

    Abstract:
    Objective To identify the risk factors, level of exposure, and the population distribution in high-risk stroke people groups with age over 40 years in Hebei and Dongli Districts of Tianjin.To explore the level of serum homocystenine(Hcy) and its influencing factors.
    Methods A total of 834 high-risk cases were accepted and divided into groups A(40~49), B(50~59), C(60~69), and D(≥70) based on age.Data were analyzed using ANOVA, Chi-square test, and binary logistic regression.
    Results The serum Hcy values were(12.25±4.54), (14.01±6.67), (15.76±8.88), and(18.21±8.99)μmol/L for groups A to D, respectively.The level of serum Hcy increased with increasing age(F=15.476, P < 0.05).The rate of males with hyperhomocysteinemia(HHcy) was significantly higher than that of females(χ2=31.034, P < 0.05).The rates in the exposed group with previous stroke history and smoking were significantly higher than those of the non-exposed group(χ2=9.888 and 18.486, both P < 0.05).The rates in exposed group with transient ischemic attack(TIA), heart disease, high blood pressure, dyslipidemia, and lack of physical exercise showed no significant difference with the non-exposed group(χ2=0.688, 0.773, 2.042, 1.427 and 0.560, all P>0.05), but the rate in exposed group with diabetes was significantly lower than nonexposed group(χ2=30.345, P < 0.05).The independent risk factors of HHcy were male(OR=2.332), smoking(OR=1.537), and previous stroke history(OR=1.946) according to the logistic regression.
    Conclusions The detection of serum Hcy is extremely important in screening high-risk populations for stroke.HHcy is an independent risk factor of stroke.It's important to take measures to reduce the incidence of stroke.

     

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