多种危险因素对老年脑卒中的协同作用
Synergistic Effect of Multiple Risk Factors on Senile Stroke

目的：研究多种危险因素对脑卒中的作用及它们之间的协同作用。方法：从医院健康体检者中，选择3401名参与者，经过筛查最终选择了2794名参与者。将他们分为患病组(病例组)，和未患病组(空白对照组)，分组的依据为是否患有脑卒中疾病，两个组分别进行了相同的调查问卷，以正常Hcy和正常血糖，无颈动脉杂音和脉率正常为对照，对指标进行哑变量设置。结果：与未患病组相比，患病组的HHcy、颈动脉杂音，高血糖和脉率不齐的患有率都高，两者在统计学上有差异(p < 0.05)。通过Logistic回归分析，对数据进行单、多因素(控制性别，年龄，血压，饮酒，锻炼，心脏杂音等)的回归分析，计算OR值，虽经调整后的OR略下降，但最后所得OR值都大于1。同时患有HHcy和高血糖，患有颈动脉杂音和脉率不齐的人与对照相比OR值分别为2.20和3.62，经因素控制分析后，OR值为1.80和3.08。结论：同型半胱氨酸、颈动脉杂音、血糖与脉率不齐均为脑卒中的危险因素，同时它们存在协同作用。
Objective: To study the effects of multiple risk factors on stroke and their synergistic effects. Meth-ods: 3401 participants were selected from the hospital physical examination, and 2794 participants were finally selected after screening. They were divided into the diseased group (case group) and the non-diseased group (blank control group). The grouping was based on whether they had stroke disease. The two groups conducted the same questionnaire. The indicators were set with dummy variables with normal Hcy and normal blood glucose, no carotid murmur and normal pulse rate as the control. Results: Compared with the control group, the incidence of HHcy, carotid murmur, hy-perglycemia and uneven pulse rate in the case group were higher, which were statistically different (p < 0.05). Through Logistic regression analysis, the data were analyzed by single and multi factor regression analysis (controlling gender, age, blood pressure, drinking, exercise, heart murmur, etc.), and the OR value was calculated. Although the adjusted OR decreased slightly, the final OR value was greater than 1. The OR values of patients with HHcy and hyperglycemia, carotid murmur and uneven pulse rate were 2.20 and 3.62 respectively compared with the control group. After control analysis, the OR values were 1.80 and 3.08. Conclusion: Homocysteine, carotid murmur, blood glu-cose and pulse rate irregularity are the risk factors of stroke, and they have synergistic effects.