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目的探讨不同的收缩压轨迹对脑出血的影响。方法以参加2006-2007、2008-2009和2010-2011年3次健康体检的开滦研究人群作为研究队列,其中符合入选标准的研究对象共55 194人。收缩压轨迹通过SAS Proc Traj程序确定;采用寿命表法计算不同收缩压轨迹组脑出血的累积发生率,并用Log-rank检验比较不同收缩压轨迹组脑出血累积发生率的差异;采用Cox比例风险模型分析不同收缩压轨迹组对脑出血的影响。结果纳入统计分析的研究对象55 194人通过SAS Proc Traj程序确定了5组不同的收缩压轨迹:低-稳定组、正常-稳定组、中-高组、高-中组和高-稳定组。平均随访(4.99±0.39)年,共发生脑出血164例。低-稳定组、正常-稳定组、中-高组、高-中组和高-稳定组脑出血的累积发生率分别为0.05%、0.20%、0.80%、0.60%和0.80%(P<0.01)。多因素Cox回归分析显示,在校正多种混杂因素后,与低-稳定组相比,正常-稳定组、中-高组、高-中组和高-稳定组脑出血的发生风险均增加,其HR(95%CI)分别为3.48(1.41~8.56)、15.01(5.67~39.71)、11.47(3.70~35.61)和18.40(5.28~64.14)。结论高收缩压轨迹是发生脑出血的独立危险因素。
Objective To investigate the effect of different systolic pressure trajectories on intracerebral hemorrhage. Methods A cohort of Kailuan population who participated in three physical examinations in 2006-2007, 2008-2009 and 2010-2011 was selected as the research cohort. A total of 55 194 eligible participants were enrolled in the study. The systolic blood pressure track was determined by the SAS Proc Traj program. The cumulative incidence of cerebral hemorrhage in different systolic blood pressure systolic trajectory groups was calculated by the life table method. The cumulative incidence of cerebral hemorrhage in different systolic blood pressure systolic blood pressure groups was compared by Log-rank test. Cox proportional hazards Model analysis of different systolic pressure trajectory of cerebral hemorrhage. Results Participants in the Statistical Analysis 55 The 194 individuals identified five different sets of systolic pressure trajectories using the SAS Proc Traj program: low-stable group, normal-stable group, medium-high group, high-medium group, and high-stable group. The average follow-up (4.99 ± 0.39) years, a total of 164 cases of cerebral hemorrhage occurred. The cumulative incidence of intracerebral hemorrhage in the low-stable group, normal-stable group, moderate-high group, high-medium group and high-stable group were 0.05%, 0.20%, 0.80%, 0.60% and 0.80% ). In the multivariate Cox regression analysis, the risk of intracerebral hemorrhage increased in the normal-stable group, the medium-high group, the high-medium group and the high-stable group after correcting for various confounding factors compared with the low-stable group, The HR (95% CI) was 3.48 (1.41-8.56), 15.01 (5.67-39.71), 11.47 (3.70-35.61) and 18.40 (5.28-64.14), respectively. Conclusion High systolic pressure track is an independent risk factor for cerebral hemorrhage.