山东省六市九医院脑卒中危险因素的病例对照研究

doi:10.3969/j.issn.1006-9771.2024.07.013

Abstract

Abstract:

Objective To investigate the risk factors of stroke in nine hospitals of six cities of Shandong, and compare the differences between residents of peninsula and inland areas.
Methods Stroke patients in nine hospitals belonging to the Rehabilitation Medicine Alliance of Qilu Hospital of Shandong Universityfrom December, 2022 to October, 2023 were selected as the case group. The control group consisted of individuals undergoing health check-ups at the same hospitals during the same period. The sample size of both groups was equal, matched by age and gender, and demographic information and medical history were collected, and the risk factors of stroke were analyzed.
Results A total of 438 cases were included. Residence in the inland (OR = 2.07, 95%CI 1.26 to 3.40， P = 0.04), smoking (P = 0.007), alcohol consumption (OR = 6.67, 95%CI 1.16 to 38.37， P = 0.019), depression (OR = 2.16, 95%CI 1.03 to 4.53， P = 0.042) and hypertension (OR = 4.15, 95%CI 2.34 to 7.39, P < 0.001) were possible risk factors of stroke. However, smoking (OR = 3.35, 95%CI 1.11 to 10.10， P = 0.013) and hypertension (OR = 2.79, 95%CI 1.12 to 6.95， P = 0.004) were possible risk factors for the prevalence of stroke among residents in peninsula areas, and obesity (excess waist circumference) (OR = 1.08, 95%CI 1.03 to 1.13， P = 0.001), depression (OR = 4.27, 95%CI 1.38 to 13.23， P = 0.013) and hypertension (OR = 4.8, 95%CI 2.21 to 10.43; P < 0.001) were possible risk factors for the prevalence of stroke among residents in the inland areas.
Conclusion Hypertension is the most likely risk factor for stroke in nine hospitals of six cities of Shandong Province. Additionally, living inland, smoking and alcohol consumption may also increase the risk of stroke. There are differences in possible risk factors for stroke between peninsula and inland residents, and targeted stroke prevention and control measures should be implemented for different regions.

Key words: stroke, risk factor, case-control study

CLC Number:

R743.3

REN Xiaomin, WEI Hui, YUE Shouwei, YIN Sen. Risk factors of stroke in nine hospitals of six cities in Shandong, China: a case-control study[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 839-847.

Figures/Tables 7

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References 27

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变量或选项	释义
体力工作为主	农民、搬运工、司机、家庭主妇等
脑力工作为主	企事业单位人员、学生等
介于体力和脑力劳动之间	个体户等
当前吸烟	以调查当前为时间节点(病例组以发病时为时间节点)，正在吸烟或在过去12个月内有吸烟行为
曾经吸烟	1年多前戒烟的人
曾经饮酒	以调查当前为时间节点(病例组以发病时为时间节点)，在此之前曾经饮酒，现已戒酒
适度饮酒	以调查当前为时间节点(病例组以发病时为时间节点)，目前每月饮酒0.1~3 kg
经常锻炼身体	每周定期进行4 h或更长时间的中、高强度运动
心理社会压力	家庭和工作场所的综合压力测量(长期或多次压力 vs. 过去1年没有或部分压力)
抑郁	过去12个月内连续2周或更长时间感到悲伤、忧郁或抑郁
经常失眠	每周失眠次数≥ 3次
经常熬夜	每周熬夜次数≥ 3次

变量	对照组(n = 217)	病例组(n = 221)	Z值	P值
BMI/(kg∙m^-2)	24.22(22.07, 26.53)	25.54(23.36，27.30)	-3.125	0.002
腰围/cm	87.40(80.00, 90.00)	87.40(80.00，99.50)	-2.299	0.021
臀围/cm	99.1(90.00, 101.00)	100.00(95.00，105.00)	-2.375	0.018
学历/n			-2.803	0.005
小学及以下	37	51
初中	69	73
高中或中专	46	66
大专/大学及以上	65	31
高血压病程/n			-8.553	< 0.001
0年	154	65
0~5年	38	72
6~10年	4	29
> 10年	21	55
糖尿病病程/n			-2.856	0.004
0年	178	154
0~5年	19	34
6~10年	2	13
> 10年	18	20
血脂异常病程/n			-3.457	0.001
0年	176	148
0~5年	31	48
6~10年	3	12
> 10年	7	13

变量	对照组(n = 217)	病例组(n = 221)	χ²值	P值
居住地			3.620	0.057
半岛	111	93
内陆	106	128
吸烟			13.594	0.001
从不吸烟	156	139
曾经吸烟	29	60
当前吸烟	32	22
饮酒			21.951	< 0.001
从不饮酒	133	119
曾经饮酒	30	57
适度饮酒	52	32
每月饮酒> 3 kg	2	13
是否抑郁			4.349	0.037
否	193	181
是	24	40
是否经常失眠			5.544	0.019
否	181	164
是	36	57
是否经常熬夜			3.707	0.054
否	159	179
是	58	42

变量	B	SE	Wald值	自由度	P值	OR(95%CI)
居住在内陆	0.727	0.254	8.213	1	0.004	2.07(1.26~3.40)
抑郁	0.769	0.379	4.124	1	0.042	2.16(1.03~4.53)
吸烟			9.904	2	0.007
曾经吸烟	0.752	0.398				2.12(0.97~4.63)
当前吸烟	-0.716	0.434				0.49(0.21~1.14)
饮酒			9.900	3	0.019
曾经饮酒	-0.193	0.422				0.83(0.36~1.88)
适度饮酒	-0.757	0.393				0.47(0.22~1.01)
每月饮酒> 3 kg	1.898	0.893				6.67(1.16~38.37)
高血压病程			47.204	3	< 0.001
0~5年	1.424	0.294				4.15(2.34~7.39)
6~10年	3.085	0.633				21.86(6.32~75.60)
> 10年	2.001	0.428				7.40(3.20~17.13)

变量	半岛地区		内陆地区		半岛地区		内陆地区
变量	对照组 (n = 111)	病例组 (n = 93)	对照组 (n = 106 )	病例组 (n = 128)	Z值	P值	Z值	P值
BMI/(kg∙m^-2)	24.54 (22.86,27.00)	25.46 (22.88,26.82)	24.19 (21.98,26.29)	25.57 (23.44,27.53)	-1.100	0.271	-3.238	0.001
腰围/cm	87.40 (80.00,93.00)	86.00 (75.50,90.00)	87.40 (78.00,89.00)	90.00 (80.00,102.00)	-1.240	0.215	-4.043	< 0.001
臀围/cm	99.10 (90.00,103.00)	99.10 (92.00,102.50)	99.10 (93.50,100.00)	100.00 (96.50,107.75)	-0.423	0.672	-2.875	0.004
学历/n					-2.625	0.009	-1.320	0.187
小学及以下	18	16	19	35
初中	30	37	39	36
高中或中专	25	30	21	36
大专/大学及以上	38	10	27	21
高血压病程/n					-4.564	< 0.001	-7.698	< 0.001
0年	73	30	81	35
0~5年	17	22	21	50
6~10年	4	15	0	14
> 10年	17	26	4	29
糖尿病病程/n					-0.897	0.370	-3.838	< 0.001
0年	80	60	98	94
0~5年	12	12	7	22
6~10年	2	12	0	1
> 10年	17	9	1	11
血脂异常病程/n					-4.270	< 0.001	-1.046	0.295
0年	86	46	90	102
0~5年	19	30	12	18
6~10年	3	9	0	3
> 10年	3	8	4	5

Risk factors of stroke in nine hospitals of six cities in Shandong, China: a case-control study

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变量	B	SE	Wald值	自由度	P值	Adjusted OR(95%CI)
半岛地区
吸烟			7.606	2	0.022
曾经吸烟	1.207	0.563				3.35(1.11~10.10)
当前吸烟	-0.312	0.638				0.73(0.21~2.56)
高血压病程			12.157	3	0.007
0~5年	1.025	0.466				2.79(1.12~6.95)
6~10年	2.187	0.689				8.91(2.31~34.40)
> 10年	0.892	0.516				2.44(0.89~6.71)
内陆地区
腰围	0.078	0.023	11.873	1	0.001	1.08(1.03~1.13)
是否抑郁	1.453	0.576	6.350	1	0.012	4.27(1.38~13.23)
高血压病程			23.133	2	< 0.001
0~5年	1.568	0.396				4.8(2.21~10.43)
> 10年	2.444	0.689				11.52(2.99~44.47)

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