摘要
目的 调查1 623例＞40岁人群缺血性脑卒中(CIS)风险现况,并构建预测模型,旨在为有效预防CIS提供科学依据.方法 2015年1月至2020年1月,采用随机抽样法抽取＞40岁1 623例作为调查对象,进行脑卒中问卷调查、体格检查和实验室检查,根据是否患有CIS分组,比较两组临床资料,通过logistic多因素回归模型分析诱发CIS的危险因素,绘制受试者工作特征(ROC)曲线分析logistic回归模型对＞40岁人群发生CIS的预测价值.结果 1 623例＞40岁入中79例确诊CIS,患病率为4.87％.患病组和未患病组年龄、高血压、糖尿病、血脂异常、卒中家族史及血清硫氧还蛋白(Trx)、甘露糖结合凝集素相关丝氨酸蛋白酶3(MASP-3)、甘露聚糖结合凝集素(MBL)水平差异有统计学意义(P＜0.05).年龄(≥60岁)、高血压、糖尿病、血脂异常、脑卒中家族史、Trx＞9.10 μg·L-1为CIS的危险因素,MASP-3＞450.40μg·L-1、MBL＞25.31 μg·L-1为CIS的保护因素(P＜0.05).年龄、高血压、糖尿病、血脂异常、脑卒中家族史、Trx、MASP-3、MBL联合预测CIS的曲线下面积(AUC)为0.831,预测敏感度为91.36％,特异度为78.52％.结论 ＞40岁人群CIS发生风险较高,主要与年龄、高血压、糖尿病、血脂异常、卒中家族史及血清Trx、MASP-3、MBL水平等因素有关.
Abstract
Objective To investigate the risk status of cerebral ischemic stroke(CIS)in1 623 patients over 40 years old,and to construct a prediction model.Methods There were 1 623 patients over 40 years old from January 2015 to January 2020 were selected by random sampling method as subjects.Questionnaire survey,physical examination and laboratory examination were conducted to investigate.Clinical data of the two groups were compared according to whether they had CIS.The risk factors of CIS were analyzed by logistic multivariate regression model,and the predictive value of CIS in people over 40 years old was analyzed by receiver operating characteristic(ROC)curve.Results A total of 1623 patients over 40 years old were included in this study,and 79 were diagnosed with CIS,with a prevalence rate of 4.87％.There were statistically differences in age,hypertension,diabetes,dyslipidemia,family history of stroke and serum levels of thioredoxin(Trx),mannose-binding lectin associated serine protease 3(MASP-3)and mannose-binding lectin(MBL)between the two groups(P＜0.05).Age(≥60 years old),hypertension,diabetes,dyslipidemia,family history of stroke,Trx＞9.10 μg·L-1were risk factors for CIS,MASP-3＞450.40 μg·L-1 and MBL＞25.31 μg·L-1 were protective factors for CIS(P＜0.05).Age,hypertension,diabetes,dyslipidemia,family history of stroke,Trx,MASP-3,and MBL combined predicted an area under curve(AUC)of 0.831,a sensitivity of 91.36％,and a specificity of 78.52％for CIS.Conclusion The risk of CIS is higher in people over 40 years old,which is mainly related to age,hypertension,diabetes,dyslipidemia,family history of stroke,serum Trx,MASP-3,MBL and other factors.
基金项目
河南省医学科技攻关计划项目(192102310349)
南阳市医学科技攻关项目(KJGG2018082)
维普
万方数据