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目的探讨蒙古族人群代谢综合征(MS)及其各组分与脑卒中的关系,为脑卒中的预防和控制提供科学依据。方法于2002年6月—2003年8月采用整群抽样方法在内蒙古通辽市朝鲁吐和固日班花乡抽取2 535名≥20岁蒙古族居民进行前瞻性队列研究,并采用多因素Cox回归模型分析MS及其各组分与脑卒中发生的关系。结果内蒙古通辽市2 535名≥20岁蒙古族人群MS、中心性肥胖、血压偏高、高甘油三酯(TG)、低高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)异常的患病率分别为27.50%、36.06%、50.73%、17.51%、54.00%、22.13%;蒙古族人群脑卒中累积发病率为4.73%,发病密度为520/10万人年,其中男、女性人群脑卒中的发病密度分别为832.54/10万人年和300.82/10万人年,缺血性脑卒中和出血性脑卒中的发病密度分别为329.14/10万人年和190.55/10万人年;多因素Cox回归分析结果显示,在调整了性别、年龄、吸烟、饮酒、心血管病家族史、体质指数(BMI)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、C-反应蛋白(hs CRP)等混杂因素后,随着MS组分聚集程度的增加,蒙古族人群总的脑卒中发生的危险性也随之增加(χ2=4.866,P=0.027),但缺血性卒中和出血性卒中发生的危险性差异均无统计学意义(均P>0.05);患MS的蒙古族人群与未患MS的人群比较,发生总的脑卒中、缺血性脑卒中、出血性脑卒中的危险性差异均无统计学意义(均P>0.05);MS各组分中,仅血压偏高与蒙古族人群总的脑卒中(HR=2.717,95%CI=1.596~4.625)、缺血性脑卒中(HR=2.084,95%CI=1.095~3.968)、出血性脑卒中(HR=4.763,95%CI=1.807~12.559)发病有关(均P<0.05)。结论 MS与蒙古族人群脑卒中的发生无关,但血压偏高是总的脑卒中、缺血性和出血性脑卒中的重要危险因素。
Objective To explore the relationship between metabolic syndrome (MS) and its components and stroke in Mongolian population and to provide a scientific basis for the prevention and control of stroke. Methods From June 2002 to August 2003, a total of 2 535 Mongolian residents aged 20 years or older were selected from the prospective cohort using a cluster sampling method in Chaupu Township, Chaupu Township, Tongliao City, Inner Mongolia, and multivariate Cox Regression analysis of the relationship between MS and its components and stroke. Results The prevalence of MS, central obesity, high blood pressure, high triglyceride (TG), low density lipoprotein cholesterol (HDL-C) and fasting plasma glucose (FPG) in 2 535 Mongolians aged 20 years or older in Tongliao City, Inner Mongolia The prevalence of stroke was 27.50%, 36.06%, 50.73%, 17.51%, 54.00% and 22.13%, respectively. The cumulative incidence of stroke was 4.73% in Mongolian population and the incidence density was 520/10 million person-years, of which the male and female population The incidence of stroke was 832.54 per 100,000 person-years and 300.82 per 100,000 person-years, respectively. The incidences of stroke and hemorrhagic stroke were 329.14 per 100,000 person-years and 190.55 per 100,000 person-year, respectively. Multivariate Cox regression analysis showed that gender, age, smoking, alcohol consumption, family history of cardiovascular disease, body mass index (BMI), total cholesterol (TC), low density lipoprotein cholesterol (LDL- (HsCRP) and other confounders, the risk of total stroke in Mongolian population also increased with the increase of MS fraction (χ2 = 4.866, P = 0.027), but ischemic There was no significant difference in the risk of stroke and hemorrhagic stroke (all P> 0.05). The Mongolian population with MS and non-suffering MS patients, the occurrence of total stroke, ischemic stroke, hemorrhagic stroke risk differences were not statistically significant (all P> 0.05); MS components, only high blood pressure and Mongolian Total stroke (HR = 2.717, 95% CI = 1.596-4.625), ischemic stroke (HR = 2.084, 95% CI = 1.095-3.968), hemorrhagic stroke (HR = 4.763, 95% CI = 1.807 ~ 12.559) (P <0.05). Conclusion MS is not associated with stroke in Mongolian population, but high blood pressure is an important risk factor for total stroke, ischemic and hemorrhagic stroke.