健康行为对原发性高血压患者脑卒中发病影响的病例对照研究  

A Case-control Study on Impact of Health Behavioral Factors on Stroke in Primary Hypertensive Patients

作　　者：赵洁[1] 张小培[2] 钟爱群 张懿[4] 徐桂红[5] 高玲玲[6] 万丽红[6] 

机构地区：[1]云南中医学院护理学院,云南省昆明市650500 [2]广东省中医院神经一科 [3]广州市越秀区第三人民医院慢性病科 [4]重庆医药高等专科学校护理系 [5]中山大学附属第三医院神经内科 [6]中山大学护理学院

出　　处：《中国全科医学》2012年第34期3963-3967,共5页Chinese General Practice

基　　金：广东省医学科研基金立项课题(A2011158)

摘　　要：目的通过搜集原发性高血压患者、原发性高血压首次并发脑卒中患者既往可能存在的各种行为危险因素的暴露史,测量两组各因素的暴露比例,探索原发性高血压患者行为因素与其脑卒中发病的关联,推断哪些行为因素是高血压患者脑卒中发病的危险因素,为脑卒中的防治提供依据。方法采用健康促进生活方式量表Ⅱ(HPLPⅡ)对广州市某两家三甲医院的原发性高血压患者进行问卷调查,按年龄、性别、高血压病程成组匹配,采用非条件Logistic回归模型进行统计分析。结果脉压差>40 mm Hg、运动锻炼、吸烟、未按量服药、未定时排便进入了多因素Logistic回归模型,OR值分别为0.198〔95%CI(0.092,0.426)〕、7.515〔95%CI(2.117,26.683)〕、7.588〔95%CI(2.124,27.111)〕、12.814〔95%CI(3.096,53.040)〕、4.446〔95%CI(1.282,15.419)〕。结论运动锻炼是延缓原发性高血压脑卒中发病的保护因素;脉压差>40 mm Hg、吸烟、未按量服药、未定时排便是原发性高血压脑卒中发病的危险因素。Objective To collect the histories of exposure to risk behavioral factors in patients with primary hypertension and hypertensive stroke, to measure the exposure proportions of case and control groups, in order to explore the behavioral factors associated with stroke in patients with primary hypertension, and to infer the risk behavioral factors of stroke so as to provide evidence for prevention and control of stroke. Methods The Health Promoting Profile II （ HPLP lI ） was used for a questionnaire survey among patients with primary hypertension from two Third - Level Grade - A Hospitals in Guangzhou. The patients were divided as case - group and control group according to their ages, sexes and disease course. Unconditional Logistic regression model was used for statistical analysis. Results The risk factors for stroke onset entering the Logistic regression model were pulse pressure 〉 40 mm Hg, physical exercise, smoking, no medication of the prescribed dose, and irregular defecation, their OR values were respectively 0. 198 [ 95% CI （0. 092, 0. 426） 1, 7. 515 [ 95% CI （2. 117, 26. 683） ], 7. 588 [ 95% CI （2. 124, 27. 111）1, 12.814 [95%C1 （3.096, 53.040）1, 4.446 [95%CI （1.282, 15.419）1. Conclusion The pbysical exercise is a protective factor to delay the stroke for primary hypertensive patients, while the pulse pressure 〉 40 mm Hg, smoking, no medication of the prescribed dose, and irregular defecation are the risk factors.

关 键 词：原发性高血压 脑卒中 健康行为 病例对照研究 

分 类 号：R255.2[医药卫生—中医内科学] R544.1[医药卫生—中医学]