吸烟、脑卒中家族史对脑卒中患病的交互作用分析  

Interaction effect of smoking and family history of stroke on stroke morbidity

作　　者：汤洪秀 王佳[1] 曾艺[1] 张雍[1] 凌瑜双 何晓晨 尤康 周琦[1] TANG Hongxiu;WANG Jia;ZENG Yi;ZHANG Yong;LING Yushuang;HE Xiaochen;YOU Kang;ZHOU Qi(Yuzhong District Center for Disease Control and Prevention,Chongqing 400010,China)

机构地区：[1]重庆市渝中区疾病预防控制中心,重庆400010

出　　处：《实用预防医学》2023年第7期781-784,共4页Practical Preventive Medicine

基　　金：国家重大公共卫生专项“脑卒中高危人群筛查与干预项目”(重庆)(渝财社[2019]137号;渝财社[2020]203号)。

摘　　要：目的 探讨吸烟、脑卒中家族史与脑卒中患病的相关性,分析两者对脑卒中的交互作用。方法 本研究数据来源于国家“脑卒中高危人群筛查与干预项目”,选取≥40岁的社区常住居民为调查对象,进行问卷调查、身体测量和实验室检测。共16 584名研究对象纳入分析。采用SPSS 19.0进行χ^(2)检验、单因素和多因素logistic回归;运用相加模型分析吸烟和家族史对脑卒中的交互作用,并计算交互效应超额相对危险度(relative excess risk due to interaction,RERI)、交互作用归因百分比(attributable proportion,AP)以及协同指数(synergy index,SI)。结果 研究对象中,脑卒中患者208例(1.25%),有脑卒中家族史者1 050例(6.33%),吸烟者1 467例(8.85%),吸烟且有家族史者有205例(1.23%)。相加模型分析交互作用结果显示,调整性别、年龄、高血压、血脂异常、糖尿病、肥胖、缺乏运动、房颤或瓣膜性心脏病、一过性短暂性脑缺血等因素后,与不吸烟且无脑卒中家族史者相比较,不吸烟有家族史者(OR=3.390, 95%CI:2.272~5.057)、吸烟无家族史者(OR=2.346,95%CI:1.464~3.759)、吸烟且有家族史者(OR=5.938,95%CI:3.318~10.624)患脑卒中风险增加。相加交互效应指标RERI、SI、AP分别为1.202(0.582~2.808)、1.322(1.335~1.412)、20.243(17.541~26.431)。结论 吸烟和家族史对脑卒中具有相加交互作用,两者同时存在时脑卒中风险高于两者单独存在时。Objective To explore the correlation of smoking and family history of stroke with stroke morbidity,and to analyze their interaction effect on stroke.Methods The data of this study were collected from the National Screening and Intervention Program for Stroke High Risk Population.Permanent residents aged≥40 years in communities were selected to serve as the subjects of a questionnaire survey,body measurement and laboratory tests.A total of 16,584 subjects were enrolled into the final analysis.SPSS19.0 software was used to performχ2 test,single-factor and multivariate logistic regression analyses.Additive models were used to analyze the interaction effect of smoking and family history on stroke.The relative excess risk due to interaction(RERI),attributable proportion(AP)of interaction and the synergy index(SI)were calculated.Results Among the subjects,there were 208(1.25%)stroke patients,1,050(6.33%)subjects with family history of stroke,1,467(8.85%)smokers,and 205(1.23%)subjects with smoking and family history.The results of interaction effect analyses based on additive models revealed that after adjusting for factors such as sex,age,hypertension,dyslipidemia,diabetes,obesity,lack of exercise,atrial fibrillation and valvular heart disease,and previous transient ischemic attack,there was an increased risk of stroke in non-smokers with family history(OR=3.390,95%CI:2.272-5.057),smokers without family history(OR=2.345,95%CI:1.464-3.759),smokers with family history(OR=5.938,95%CI:3.318-10.624)compared with non-smokers without family history.RERI,SI and AP were 1.202(0.582-2.808),1.322(1.335-1.412)and 20.243(17.541-26.431)respectively.Conclusion There are additive interactions between smoking and family history on stroke.The risk of stroke is higher in subjects simultaneously having smoking and family history than in ones having either smoking or family history.

关 键 词：脑卒中 吸烟 家族史 交互作用 患病率 

分 类 号：R743.3[医药卫生—神经病学与精神病学]