老年人群缺血性脑卒中与血脂异常的关系

摘要

目的 调查分析社区老年人群中血脂异常及其4个组分与缺血性脑卒中患病之间的关系.方法 采用病例对照的研究思路,纳入受试者2080例,其中脑卒中组241例,非脑卒中组1839例.采用logistic多元回归分析控制性别、年龄、婚姻状况、受教育年限、吸烟、饮酒、体质量指数和锻炼情况以发现血脂异常及其组分对缺血性脑卒中的独立效应.结果 脑卒中组与非脑卒中组年龄、吸烟情况和锻炼时间比较,差异有统计学意义(P＜0.05,P＜0.01).校正前血脂异常者患缺血性脑卒中的危险性是血脂正常者的1.13倍(95％CI:0.86～1.47,P=0.391);高TG血症者患缺血性脑卒中的危险性是血脂正常者的1.51倍(95 ％CI:1.15～2.00,P=0.004).女性老年人群中,高TG血症者患缺血性脑卒中的危险性是血脂正常者的1.78倍(95％CI:1.24～2.55,P=0.002).多因素校正后,与年龄≥80岁的老年人群比较,年龄＜80岁的老年人群高TG血症造成缺血性脑卒中的危险性增高1.57倍(95％CI:1.10～2.23,P=0.012).结论 老年人群中,高TG血症可增加缺血性脑卒中患病风险,且独立于血脂异常其他3个组分存在,在女性人群和＜80岁人群中表现更为显著,应加强相关人群的健康宣教和预防干预.%Objective To investgate dyslipidemia in community elderly population and analyze the association between its 4 components and ischemic stroke.Methods A total of 2080 patients were divided into ischemic stroke group (n=241) and non-ischemic stroke group (n=1839).Their gender,age,education level,smoking amd alcohol drinking history,BMI and physical exercise were analyzed by logistic regression analysis to display the effect of dyslipidemia and its components on ischemic stroke.Results The age was older,the smoking history and physical exercise time were longer in ischemic stroke group than in non-ischemic stroke group (P＜0.05,P＜0.01).The risk of ischemic stroke was 1.13-fold,1.51 fold and 1.78-fold higher respectively in patients with dyslipidemia than in those with ortholiposis,in patients with a high serum TG level than in those with ortholiposis,and in female elderly patients with a high serum TG level than in those with a normal serum TG level (95％CI:0.86-1.47,P=0.391;95％CI:1.15-2.00,P=0.004;95％CI:1.24-2.55,P=0.002).Multivariate logistic regression analysis showed that the risk of ischemic stroke was 1.57-fold higher in ＜80 years old female patients with a high serum TG level than in ≥80years old female patients with a high serum TG level (95％CI:1.10-2.23,P=0.012).Conclusion High serum TG increases the risk of ischemic stroke and is independent of the other 3 components of dyslipidemia in elderly population,especially in female and ＜80 years old population,health education and preventive intervention should thus be strengthened for such populations.