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目的研究上海市城镇社区50岁及以上高血压、糖尿病患者脑血流动力学的变化,为社区人群脑卒中的预防提供依据。方法以整群抽样的方法抽取上海市2个社区的50岁及以上的2 031名居民为研究对象,根据基线调查结果分为对照组(无高血压和糖尿病,881名)、高血压组(781例)、糖尿病组(112例)和高血压糖尿病组(257例),进行血流动力学检测,计算脑血流动力学积分值。结果对照组、高血压组、糖尿病组和高血压糖尿病组的脑血流动力学积分值分别为(80.4±23.4)、(67.9±28.0)、(73.0±24.3)和(56.3±30.3)分,差异有统计学意义(F=66.954,P<0.01),积分值随着年龄的增长而降低。对照组、高血压组、糖尿病组和高血压糖尿病组脑血流动力学积分异常率(<75分)分别为28.6%、48.9%、41.1%和67.3%,差异有统计学意义(χ2=147.869,P<0.01),积分值异常随着年龄的增长而升高。将脑血流动力学积分值按四分位数分组,4组人群积分值的分布差异有统计学意义(χ2=181.951,P<0.01),低分(P0~P25)比例较高的依次是高血压糖尿病组、高血压组、糖尿病组和对照组。结论高血压和糖尿病均可导致脑血管血流动力学异常加重,应加强高血压合并糖尿病患者的脑卒中预防。
Objective To study the changes of cerebral hemodynamics in Shanghai urban population aged 50 years and older with hypertension and diabetes mellitus, and to provide basis for the prevention of stroke in community population. Methods A total of 2 031 residents aged 50 years and older from 2 communities in Shanghai were enrolled in this study. According to the baseline survey results, they were divided into control group (881 without hypertension and diabetes), hypertension group ( 781 cases), diabetes mellitus group (112 cases) and hypertensive diabetic group (257 cases). The hemodynamic parameters were calculated and the cerebral hemodynamic parameters were calculated. Results The scores of cerebral hemodynamics in the control group, hypertension group, diabetic group and hypertensive diabetic group were (80.4 ± 23.4), (67.9 ± 28.0), (73.0 ± 24.3) and (56.3 ± 30.3) The difference was statistically significant (F = 66.954, P <0.01), the integral value decreased with age. The abnormalities of cerebral hemodynamics scores (<75 points) in control group, hypertension group, diabetic group and hypertensive diabetic group were 28.6%, 48.9%, 41.1% and 67.3%, respectively, with statistical significance (χ2 = 147.869 , P <0.01). The abnormality of integral value increased with age. The integral of cerebral hemodynamics was divided into four quartiles. There were significant differences in the distribution of the integral values among the four groups (χ2 = 181.951, P <0.01), and the higher scores of low scores (P0 ~ P25) were Hypertensive diabetic group, hypertension group, diabetic group and control group. Conclusions Hypertension and diabetes mellitus can lead to abnormal hemodynamics of cerebrovascular disease. Stroke prevention should be strengthened in hypertensive patients with diabetes mellitus.