膳食纤维及常见危险因素对广州社区脑梗死发病的影响  

Effects of dietary fiber and common risk factors on the onset of cerebral infarction in Guangzhou communities

作　　者：黄海彬[1] 赵秋革 方晓涛 叶凤仪 吴嘉茜 曾子淇 叶琛[3] 沈粤春[4] 田作军[1] HUANG Hai-bin;ZHAO Qiu-ge;FANG Xiao-tao;YE Feng-yi;WU Jia-qian;ZENG Zi-qi;YE Chen;SHEN Yue-chun;TIAN Zuo-jun(Department of Neurology,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510120, China)

机构地区：[1]广州医科大学附属第一医院神经内科,广东广州510120 [2]广州市番禺区市桥街北片社区卫生服务站,广东广州511400 [3]广州医科大学临床医学系,2012级本科生广东广州510182 [4]广州医科大学附属第一医院心内科,广东广州510120

出　　处：《热带医学杂志》2019年第1期60-64,F0002,共6页Journal of Tropical Medicine

基　　金：广东省科技厅社会发展项目(2013B021800282;2014A020212350;2014A020212364);广州市科技计划项目(201510010181)

摘　　要：目的探讨膳食纤维(DF)及常见危险因素对广州社区脑梗死发病的影响。方法收集2015年5月至2017年11月本院收治的广州社区(海珠、越秀、荔湾、番禺、白云)本地脑梗死患者及高危人群326例,评估其日均摄入DF,并收集血压、血脂、血糖等临床资料。先根据头颅磁共振弥散成像结果将患者分为脑梗死组(98例)和非脑梗死组(228例),与DF及常见危险因素间行单因素、多因素及ROC曲线分析;再将DF以10 g和25 g为界分三组,分析三组间临床参数的差异。结果脑梗死组收缩压(SBP)、舒张压(DBP)、颈动脉斑块Crouse评分、空腹血糖(FBG),及性别(男)、糖尿病和颈动脉斑块的比率均高于非脑梗死组;而DF、高密度脂蛋白(HDL)低于非脑梗死组,差异均有统计学意义(P<0.05)。Logistic回归分析显示,脑梗死发病主要与Crouse评分(OR=1.125,P=0.026)、SBP(OR=1.029,P=0.021)有关;而DF(OR=0.941,P=0.010)及HDL(OR=0.260,P=0.022)对其有一定保护作用。ROC曲线下面积(AUC)显示,SBP与脑梗死发病相关性较密切(AUC=0.715,P=0.000)。Ordinal回归分析显示,DF三组间脑梗死发病率、年龄、SBP、DBP及糖化血红蛋白(HBA1C)差异均有统计学意义(P<0.05)。结论广州社区患者脑梗死发病主要与其Crouse评分及SBP升高有关,而DF和HDL水平上调对其脑梗死发病有保护作用;DF主要通过调节SBP、DBP及HBA1C的水平而影响脑梗死发病。Objective To investigate the effects of dietary fiber( DF) and common risk factors on the onset of cerebral infarction in Guangzhou communities. Methods 326 patients were collected from Guangzhou communities. The daily average DF intake was estimated, and the clinical data such as blood pressure, blood lipid and blood glucose were collected. Firstly, the patients were divided into cerebral infarction Group(98 cases) and non-cerebral infarction Group(228 cases) according to the findings on the brain diffusion weighted image;and the univariate and multivariate analysis and ROC curve were used to explore the risk factors affecting the onset of cerebral infarction. Afterward, the data was divided into three groups based on DF<10 g, 10-25 g and ≥25 g, and the differences of clinical parameters were analyzed among the three groups. Results In cerebral infarction group, the levels of systolic pressure( SBP), diastolic pressure(DBP), fasting blood glucose( FBG), carotid plaque Crouse score and as well as the ratios of sex, diabetes and carotid plaque were respectively higher than those in non-cerebral infarction group(all P<0.05);and DF intake and high-density lipoprotein( HDL) level were lower than those in non-cerebral infarction group(both P<0.05). Logistic regression revealed that the onset of cerebral infarction was mainly related to Crouse score( OR=1.125 P=0.026) and SBP level(OR=1.029, P=0.021);and the DF intake(OR=0.941, P=0.010) and HDL level increase(OR=0.260, P=0.022) had certain protective effect on the onset of cerebral infarction. The area under curve(AUC) of ROC also showed that SBP level was closely related to the onset of cerebral infarction(AUC=0.715, P=0.000). Ordinal regression revealed that there were significant differences of the incidence of cerebral infarction, age as well as the levels of SBP, DBP and glycosylated hemoglobin(HBA1C) among the three DF groups(all P<0.05). Conclusions The onset of cerebral infarction in Guangzhou communities was mainly related to increase of Crouse score and SBP

关 键 词：膳食纤维 脑梗死 危险因素 社区研究 

分 类 号：R743[医药卫生—神经病学与精神病学]