基于广州生物库队列的轻度认知障碍与卒中死亡关系的巢式病例对照研究  

Relationship between mild cognitive impairment and stroke mortality:a nested case-control study based on the Guangzhou Biobank Cohort Study

作　　者：陆泽雄 江朝强[2] 胡志兵 朱峰[2] 张维森 徐琳[3] 靳雅丽[2] 林大庆[4] LU Ze-xiong;JIANG Chao-qiang;HU Zhi-bing;ZHU Feng;ZHANG Wei-sen;XU Lin;JIN Ya-li;LAM Tai-hing(Department of Neurology,the 12th Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong Province 510620,China)

机构地区：[1]广州医科大学附属市十二人民医院神经内科,广东省广州510620 [2]广州市第十二人民医院分子流行病学研究室 [3]中山大学公共卫生学院流行病教研室 [4]香港大学公共卫生学院社会医学系

出　　处：《中国慢性病预防与控制》2018年第12期890-894,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：广州市科技计划(对外合作)项目(201704030132)

摘　　要：目的探讨轻度认知障碍(mild cognitive impairment,MCI)与卒中死亡的关系,为卒中的防控工作提供科学参考,方法基于广州生物库中老年队列,排除基线已有卒中或冠心病者,采用巢式病例对照研究模式,以2003年9月至2008年2月入组队列并在随访期确认死亡原因为卒中的160名研究对象为病例组,1:4匹配同期参加队列的640名生存者为对照组;以单词延迟记忆测试(Delayed word Recall Test.DWRT)得分低于4分作为MCI的评估指标。应用SPSS22.0软件进行t检验、χ^2检验,用条件logistic回归模型对MCI与卒中死亡的关系进行分析。结果病例组DWRT得分低于4分者43人.对照组DWRT得分低于4分者108人,病例组的MCI患病率(26.9%)高于对照组(16.9%),差异有统计学意义(P<0.01)。以认知功能正常作为参照,在调整了年龄、性别、糖尿病、高血压、血脂异常、吸烟、饮酒、体质指数、体力活动、睡眠时间及教育程度后,MCI增加卒中死亡风险(OR=1.60,95%CI:1.04~2.46,P<0.05)。结论卒中前MCI与卒中死亡风险增高相关,提示MCI早期筛查与有效干预对减少卒中死亡具有积极意义。Objective To explore the relationship between mild cognitive impairment (MCI)and stroke mortality,and to provide the scientific basis for preventing and controlling the stroke.Methods The nested case-control study was based on the Guangzhou Biobank Cohort Study.After excluding the patients with stroke and coronary heart disease at baseline,from September of 2003 to February of 2008,160 cases died from stroke during the follow-up period in cohort study served as the subjects,640 survivors served as the controls (1:4):the score<4 of Delayed Word Recall Test (DWRT)served as assessing indicator of MCI. The t test,χ^2 test and the conditional logistic regression model were used to analyze the data for the relationship between MCI and death from stroke.The used software was SPSS 22.0.Results There were 43 cases with score <4 of DWRT in the subject group and 108 cases with score <4 of DWRT in the control group.MCI morbidity (26.9%)in the subject group was significantly higher than that (16.9%)in the control group (P<0.01).Compared with the group of normal cognitive function,after adjusting age,sex, diabetes,hypertension,dyslipidemia,smoking,drinking,body mass index,physical activity,sleep duration and education level, MCI increased the risk of stroke mortality (0R=1.60,95%CI:1.04-2.46,P<0.05).Conclusion Pre-stroke MCI was associated with the increased risk of stroke mortality,which suggested that the early screening and effective intervention of MCI may reduce the stroke mortality.

关 键 词：卒中 死亡 轻度认知障碍 单词延迟记忆测试 巢式病例对照研究 

分 类 号：R743[医药卫生—神经病学与精神病学]