农村地区脉压及脉压指数与脑卒中患病率关系的研究

目的探讨农村地区脉压（PP）及脉压指数（PPI）与脑卒中的相关性。方法采用分层整群抽样方法对阜新农村地区〉135岁居民29970人进行流行病学调查,使用Epidata．3．1建立数据库,SPSS11．5软件进行统计分析。结果（1）PP在卒中组与非卒中组分别为,男65mmHg±19mmHg（1mmHg=0．133kPa）和52mmHg±14mmHg,女70mmHg±21mmHg和53mmHg±17mmHg;PPI在两组分别为,男0．40±0．08和0．38±0．07,女0．42±0．08和0．39±0．07。卒中组PP、PPI均高于非卒中组,其差异有统计学意义（P〈0．01）。（2）随PP水平的升高、PPI的增大,不同性别的卒中患病率均呈增加趋势（趋势X^2检验P〈0．01）。（3）ROC曲线分析：取最佳界值时ROC曲线下面积,男性PP为0．720（95％CI0．694～0．746）,PPI为0．581（95％CI0．553～0．610）;女性PP为0．755（95％CI0．727～0．784）,PPI为0．681（95％CI0．583～0．650）;PP与PPI曲线下面积差异有统计学意义（P〈0．01）。结论脉压与脉压指数均与脑卒中有关,为脑卒中的危险因素,脉压预测脑卒中患病优于脉压指数。

Relationship between pulse pressure, pulse pressure index and prevalence of stroke among rural population in China

OBJECTIVE: To investigate the association between pulse pressure (PP), pulse pressure index (PPI), and stroke in rural areas. METHODS: 29970 people>or=35 years old in rural areas of Fuxin City, Liaoning Province, were selected by cluster multistage sampling. Blood pressure was measured. History of stroke was taken. SPSS11.5 statistical software was used for data analysis. RESULTS: (1) The prevalence of stroke was 2.48%. (2) The PP level of the stroke group was 65 mm Hg+/-19 mm Hg in men and 70 mm Hg+/-21 mm Hg in women; while the PP level of the non-stroke group was 52 mm Hg+/-14 mm Hg in men and 53 mm Hg+/-17 mm Hg in women. The PPI level of the stroke group was 0.40+/-0.08 in men and 0.42+/-0.08 in women; while the PPI of the non-stroke was 0.38+/-0.07 in men and 0.39+/-0.07 in women. The PP and PPI levels of the stroke group were significantly higher than those of the non-stroke group (both P<0.01). (2) The prevalence of stroke increased along with the increase of PP and PPI in both genders (both P<0.01). (3) Receiver operating characteristic (ROC) curve analysis showed that the areas of PP and PPI under ROC curve was 0.720 (95% CI, 0.694-0.746) and 0.581 (95% CI, 0.553-0.610) in men when the optional cutoff was selected; and were 0.755 (95% CI, 0.727-0.784) and 0.681 (95% CI, 0.583-0.650) in women. The sensitivity in prediction of stroke of PP was higher than that of PPI; and the specificity in prediction of stroke of PP was lightly lower than that of PPI in men and was higher than that of PP in women. The area of PP under ROC curve was significantly larger than that of PPI (P<0.01). CONCLUSIONS: As risk factors of stroke, PP and PPI are associated with the prevalence of stroke. PP is superior to PPI in predicting the prevalence of stroke.