心血管疾病家族史和吸烟对缺血性脑卒中发病的联合效应  

Combined effects of both cardiovascular disease family history and smoking on the incidence of ischemic stroke

作　　者：陆芹[1] 张建辉[2] 刘永跃[3] 陆红敏 田芸凡 布仁巴图[3] 周逸鹏[1] 张永红[1] 

机构地区：[1]苏州大学医学部公共卫生学院流行病与卫生统计学教研室江苏省老年预防与转化医学重点实验室,215123 [2]内蒙古自治区通辽市医院神经内科,028000 [3]内蒙古自治区通辽市疾病预防控制中心疾病控制科,028000

出　　处：《中华流行病学杂志》2016年第4期475-479,共5页Chinese Journal of Epidemiology

基　　金：国家自然科学基金（30972531）

摘　　要：目的 探讨蒙古族人群心血管疾病家族史和吸烟的联合作用与缺血性脑卒中事件发生的关系。方法 2002-2003年在完成2589名蒙古族研究对象基线调查的基础上,进行10年随访观察,将缺血性脑卒中作为终点事件。按心血管疾病家族史与吸烟状况将2589名研究对象分为无心血管疾病家族史/不吸烟、无心血管疾病家族史/吸烟、心血管疾病家族史/不吸烟、心血管疾病家族史/吸烟四组。以Kaplan-Meier（K-M）方法描述4个组研究对象的缺血性脑卒中累积发病率。应用Cox比例风险模型,估计发生缺血性脑卒中的风险比（HR）及其95%CI。结果 K-M分析结果显示,上述4个组的累积发病率分别为1.17%（15/1278）、3.83%（37/967）、5.70%（9/158）、8.33%（15/180）。经Cox模型分析,在调整年龄、男性、饮酒情况、SBP、DBP、BMI、FPG、TC、TG、LDL-C后,与无心血管疾病家族史/不吸烟组相比,无心血管疾病家族史/吸烟组、有心血管疾病家族史/吸烟组的HR值分别为2.26（95%CI：1.19-4.28）和2.45（95%CI：1.13-5.33）,差异均有统计学意义（P〈0.05）,以心血管疾病家族史/吸烟组发生缺血性脑卒中的危险性最高。结论 具有心血管疾病家族史的吸烟人群可增加缺血性脑卒中的危险性。Objective To investigate the cumulative effect regarding the family history of cardiovascular disease and smoking on ischemic stroke events in population with Mongolian ethnicity. Methods Based on data gathered from the baseline investigation, a 10-year prospective cohort follow-up project was conducted among 2589 participants with Mongolian ethnicity. Ischemic stroke events were defined as the outcomes of the study. All the 2589 participants were categorized into four subgroups：without family history of cardiovascular disease/nonsmokers, without family history of cardiovascular disease/smokers, with family history of cardiovascular disease/nonsmokers and with family history of cardiovascular disease/smokers, according to family history of cardiovascular disease and smoking status. Cumlative incidence rates of events among the four subgroups was described with Kaplan-Meier curves. Cox proportional hazards model was used to estimate the hazard ratios（HRs） and 95% confidence intervals（95%CI） of ischemic stroke events among the four subgroups. Results Data from the Kaplan-Meier curves showed that the cumulative incidence rates of ischemic stroke were 1.17%（15/1278）, 3.83%（37/967）, 5.70%（9/158） and 8.33%（15/180） for the groups of no family history of cardiovascular disease/nonsmokers, no family history of cardiovascular disease/smokers, with family history of cardiovascular disease/nonsmokers and with family history of cardiovascular disease/smokers, respectively. By cox proportional hazards model, after adjusting for age, male, drinking status, systolic and diastolic blood pressure, body mass index, fasting glucose, total cholesterol, triglycerides, LDL cholesterol factors, the HRs（95%CI） of ischemic stroke were 2.26（1.19-4.28） and 2.45（1.13-5.33） in the no family history of cardiovascular disease/smokers group, with family history of cardiovascular disease/smokers group when compared to the no family history of cardiovascular disease/nonsmokers group, respectively. The risk of

关 键 词：缺血性脑卒中 心血管疾病家族史 吸烟 

分 类 号：R743.3[医药卫生—神经病学与精神病学]