青年出血性脑卒中的相关危险因素

目的探讨青年出血性脑卒中的相关危险因素。方法收集105例青年出血性脑卒中患者和105例健康体检者的临床资料,分析青年出血性脑卒中发病的相关危险因素。结果与正常对照组比较,脑卒中组吸烟、糖尿病、心脏病、高血压、高脂血症、超重、脑卒中病史及家族史的比率显著高于正常对照组(P0.05~0.01)。单因素分析显示,高血压病、糖尿病、高脂血症、超重、脑卒中病史及家族史、心脏病与青年出血性脑卒中发病相关(P0.05~0.01)。多因素非条件Logistic回归分析显示,高血压病、超重、脑卒中病史及家族史是青年出血性脑卒中的独立危险因素(OR=10.391,95%CI:4.779~22.594;OR=2.990,95%CI:1.420~6.295;OR=3.328,95%CI:1.447~9.080;OR=3.625,95%CI:1.421~7.791;均P0.01)。结论高血压病、肥胖、脑卒中病史及家族史是青年出血性脑卒中发病的独立危险因素。     

载脂蛋白Eε4和ε2等位基因与胎儿宫内发育的关系

目的 研究载脂蛋白E(ApoE)ε4和ε2等位基因与胎儿宫内发育的关系.方法 以聚合酶链反应.限制性片段长度多态性分析(PCR-RFLP)方法 检测1418名北京协和医院出生人群的ApoE基因型,计算等位基因频率,收集其出生时的相关指标.通过单因素分析和多因素Logistic回归分析比较ApoE ε4和ε2等位基因与新生儿发育状态的关系.结果 本研究人群中ApoE ε2、ε3和ε4 等位基因频率分别为8.11%、83.39%和8.50%.单因素分析结果 表明,携带ε2等位基因者的出生体质量指数(ponderal index,PI)构成差异有统计学意义(χ2=4.87,P=0.027),其头围、胎盘质量和孕周构成差异没有统计学意义.多因素分析结果 表明,调整了性别、年龄、出生头围、胎盘质量、孕周、产次和产妇年龄等因素,携带ApoE ε2等位基因与小PI呈负相关(χ2=5.077,P=0.024).没有发现携带ApoE ε4等位基因与新生儿发育状态存在关联性.结论 ApoE ε2等位基因对PI有保护作用,没有发现ApoE ε4等位基因与胎儿宫内发育有关.     

烟台市城乡脑卒中危险因素的暴露水平比较分析

目的 探讨烟台市城乡居民脑卒中患病率及危险因素的暴露水平。方法 采取整群抽样的方法从烟台莱州市永安路社区和平里店镇抽取≥40岁常住居民5 700人进行问卷调查和体格检查,对调查数据进行统计分析。结果 烟台市脑卒中总体患病率为1.54%,城乡脑卒中患病率无明显差异。纳入调查人群中高危人群707人,占12.4%; 中危人群290人,占5.09%; 低危人群4 500人,占78.95%。烟台市城市组前3位危险因素是超重或肥胖、运动缺乏、高血压病; 烟台市乡镇组前3位危险因素是超重或肥胖、高血压病、有脑卒中家族史。除脑卒中家族史外,烟台市城市组其他危险因素均高于烟台市乡镇组(P<0.05)。结论 烟台市城市居民脑卒中危险因素的暴露水平明显高于乡镇地区; 超重和肥胖已成为烟台市城乡居民首位危险因素。     

上海市静安区社区老年人群体质指数与轻度认知损害的关联研究

目的探讨社区老年人群体质指数(BMI)与轻度认知损害(MCI)之间的关联性。方法对上海市静安区静安寺街道的社区老年受试者测量身高和体重并计算BMI。应用全套神经心理测验评估研究对象的认知功能,按照Peterson标准确立MCI诊断。采用多因素Logistic回归模型分析BMI与MCI的关联性并评估关联强度。结果 3597例社区受试者中诊断MCI 696例(19.3%,95%CI:18.0～20.6)。多因素Logistic分析发现,BMI作为连续性变量与MCI的风险呈现"U"型趋势。相较于BMI为19.5～27.0的受试者,BMI19.5的受试者MCI患病风险增高(OR=1.473,95%CI:1.024～2.089);BMI27.0的人群MCI患病风险呈上升趋势(OR=1.026,95%CI:0.810～2.089)。结论社区老年人群中消瘦与MCI患病风险呈显著相关。     

脑微出血在不同脑血管病患者中的患病率及相关危险因素分析

目的研究不同脑血管病患者中脑微出血的患病率及相关危险因素,并探讨其临床意义。方法对连续入组的385例神经内科住院患者中常规行核磁共振T2梯度回波加权扫描,并登记所有患者的基线资料,分析不同类型脑血管病患者脑微出血的患病率,采用Logistic回归分析探索脑微出血的相关危险因素。结果脑出血、脑梗死、短暂性脑缺血发作及脑白质病患者中脑微出血的患病率分别为68.75%、49.52%、12.5%及63.13%;多变量Logistic回归分析显示脑微出血的相关危险因素为男性(OR=0.45,P=0.01)、高血压病(OR=2.92,P=0.01)、脑白质病(OR=9.57,P=0.00)、脑梗死(OR=2.91,P=0.00)及脑出血(OR=13.09,P=0.00)。结论脑出血、脑梗死及脑白质病患者中脑微出血患病率较高,脑微出血的相关危险因素为男性、高血压病、脑梗死、脑白质病及脑出血。     

长沙市乡村居民脑卒中危险因素调查及颈动脉粥样硬化斑块影响因素分析

目的调查长沙市乡村居民脑卒中相关危险因素并分析颈动脉粥样硬化斑块的影响因素。方法通过问卷调查、体格检查、血糖和血脂的检测收集长沙市潭阳村40岁以上的常住居民脑卒中相关危险因素并进行风险评估;对高危人群进行颈动脉彩色超声检查,并分为斑块组和无斑块组;采用单因素分析和多因素logistic回归模型对颈动脉粥样硬化斑块影响因素进行分析。结果长沙市潭阳村居民常见危险因素为血脂异常(45.8%)、吸烟(37.8%)、高血压病(30.9%)、明显超重及肥胖(22.4%)、家族史(11.3%)、缺乏运动(8.7%)、糖尿病(7.0%)。男性吸烟率较女性高(P<0.05);女性血脂异常和高血压患病率较男性高(P<0.05)。单因素分析显示斑块组较对照组年龄更高、糖尿病和高血压病患病率更高(P<0.05)。logistic多元回归分析显示糖尿病、高血压病、年龄是颈动脉粥样硬化斑块的危险因素(OR值分别为2.918、1.643、1.531)。结论长沙市40岁以上乡村居民常见的脑卒中危险因素是高血压病、糖尿病、血脂异常、明显超重及肥胖、吸烟;危险因素暴露率较高且有性别差异;颈动脉粥样硬化斑块的形成主要与糖尿病、高血压病、年龄有关。     

社区精神分裂症患者低体重率及相关因素分析

目的探讨精神分裂症患者低体重率及相关社会人口学和临床特征危险因素。方法纳入503例社区精神分裂症患者与323名健康对照,以体质指数小于18.5 kg/m2定义低体重,比较两组低体重率;收集患者组社会人口学资料、临床资料以及实验室检查指标,阳性和阴性症状量表中文版(positive and negative syndrome scale,PANSS)评估患者精神症状,分析患者低体重的相关因素。结果社区精神分裂症患者低体重率为9.9%(50/503),对照组为1.5%(5/323),组间差异有统计学意义(P0.01)。多因素logistic回归分析显示,男性(OR=2.43,95%CI:1.74~3.39)、吸烟(OR=1.50,95%CI:1.21~1.86)、住院次数(OR=1.18,95%CI:1.06~1.31)、PANSS阴性症状因子分(OR=1.09,95%CI:1.04~1.14)是低体重的危险因素(均P0.05)。结论精神分裂症患者体重不足较为常见,远高于健康人群,需要重点关注男性、吸烟、多次住院及阴性症状突出的患者。     

心血管危险因素对阿尔茨海默病的影响

目的 探讨心血管危险因素对社区老年人群阿尔茨海默病(AD)的影响.方法 采用多级整群抽样的方法抽取贵阳城区26个社区的3229名60岁以上老年人为调查对象,详细询问老年人一般资料、生活习惯、慢性病史等资料,并进行血压、身高、体重的测量,采用SPSS10.0软件进行单因素分析和多因素非条件Logistic回归分析.结果 长期服用抗高血压药物的高血压患者发生AD的危险性较低(OR=0.089,95% CI,0.012～0.650,P<0.05).收缩压水平≥180mmHg及舒张压水平≥110mmHg的老年人患AD的危险性较高(OR均>1,P<0.05).结论 长期服用抗高血压药物可能是AD的保护性因素,重度高血压与AD患病危险性有密切联系.     

中国北方城乡居民脑出血危险因素分析

目的分析中国北方城乡脑出血危险因素的差异,为城乡脑出血提供精准预防。方法收集中国北方各省市40岁以上人群资料,分为城市和乡镇组,利用条件匹配方法分析城乡脑出血的危险因素,并对其危险因素进行比较。结果收集191625人,脑出血患者559人,城乡各251和308人,高血压[OR 95%CI(9.07,6.25～13.16)vs.(7.67,5.20～11.32)]、缺乏运动[OR 95%CI(2.18,1.59～2.98)vs.(1.89,1.36～2.62)]对乡镇脑出血影响作用更强,卒中家族史[OR 95%CI(5.40,3.48～8.36)vs.(5.09,3.37～7.68)]、糖尿病[OR 95%CI(2.41,1.55～3.75)vs.(1.98,1.21～3.23)]、明显超重[OR 95%CI(2.38,1.69～3.35)vs.(1.71,1.26～2.32)]对城市脑出血作用更明显。结论以不同的危险因素对城乡的影响为依据,采取更有效的预防措施。     

血浆同型半胱氨酸与缺血性脑血管病关系的研究

目的探讨血浆同型半胱氨酸（Hcy）水平与缺血性脑血管病的关系。方法将87例患者分为缺血性脑血管病组（67例,其中脑梗死组45例,短暂性脑缺血发作组22例）和对照组（20例）,检测所有受试对象血浆Hcy水平并记录患者的脑血管病传统危险因素。分析血浆Hcy与缺血性脑血管病的相关性。结果与血浆Hcy水平在最低四分位人群相比,处于较高四分位者患缺血性脑血管病的比值比（OR）为5.278（95%CI为1.203～23.158,P〈0.05）;处于最高四分位者患缺血性脑血管病的比值比（OR）为7.917（95%CI为1.473～42.538）;与非高同型半胱氨酸血症（Hhcy）患者相比,Hhcy患者患缺血性脑血管病的OR值为4.325（95%CI为1.156～16.174,P〈0.05）;缺血性脑血管病组、脑梗死组与TIA组患者血浆Hcy水平均高于对照组（P〈0.05）,但脑梗死组与TIA组血浆Hcy水平相比较无差异（P〉0.05）;采用多因素Logistic回归分析,血浆Hcy进入模型。结论血浆Hcy水平升高可能是与传统危险因素无关的缺血性脑血管病的独立危险因素,我们有必要制订出适合于中国人的Hhcy的诊断标准。     

Birth measures and depression at age 31 years: the Northern Finland 1966 Birth Cohort Study

The aim of the study was to explore whether there is an association between body size at birth measured by birth weight and ponderal index and later depression at the age of 31 years. The analyses were based on 4007 males and 4332 females born in 1966 in the two northernmost provinces of Finland with data on current depression measured by the Hopkins Symptom Checklist-25 questionnaire (HSCL-25) and self-reported physician-diagnosed lifetime depression at 31 years and childhood characteristics. The associations between birth measures and later depression were analysed with several confounding factors including maternal depression during pregnancy. Low birth measures did not associate with adult depression in men or women. Women with high birth weight (>/=4500 g) had a higher risk for current depression compared to women with birth weight 3000 g-3499 g. Women with high ponderal index (the highest 90-95 percentiles and >/=95 percentiles) had a 1.53-1.55 higher likelihood for current depression compared with women with normal ponderal index. Based on this study, large body size at birth may be a risk factor for later depression.     

Adult Mental Health Outcomes of Preterm Survivors Experiencing Suicidal Ideation in Adolescence

The aim of this study was to examine the link between suicidal ideation in adolescence (age 12–16) and symptoms of psychopathology in adulthood (age 22–26) in a birth cohort of extremely low birth weight (ELBW; <1000g) survivors and matched normal birth weight (NBW; >2500?g) control participants. This study utilized data from a longitudinally followed cohort of 129 ELBW survivors and 116 NBW individuals born in Ontario, Canada between the years 1977 and 1982. Participants self-reported suicidal ideation via questionnaire during adolescence (age 12–16). The depression, anxiety, inattention, and antisocial behavior subscales of the Young Adult Self Report (YASR) were used to assess symptoms of psychopathology during adulthood (age 22–26). Associations were examined in each birth weight group separately prior to and after adjustment for covariates. Before and after adjustment for covariates, suicidal ideation in NBW adolescents predicted symptoms of depression, anxiety, inattention, and antisociality in adulthood. Suicidal ideation among ELBW adolescents predicted inattentive and depressive symptoms, and antisocial behavior only before adjustment. Adolescents born at NBW who endorse suicidal ideation are at elevated risk for developing symptoms of anxiety, depression, inattention, and antisocial problems in adulthood even after adjustment. Among ELBW survivors, the risks were lower and appear to be due to confounding factors.     

Antenatal and delivery risk factors and prevalence of cerebral palsy in Duzce (Turkey)

This cross-sectional study aimed at investigating the prevalence and the etiological factors of cerebral palsy (CP) and comparing them with normal population within the rural and urban areas of Duzce province. Of the 102 children with cerebral palsy, 98 were associated with antenatal and delivery risk factors. The mean crude prevalence of cerebral palsy was 1.1 per 1000 live births. The children with CP were compared with 530 control subjects. The mothers of the children with cerebral palsy were significantly younger than the mothers of children in control group, and they had less parity and abortion. Preeclampsia, premature rupture of membranes, home births, prolonged labor, and twin pregnancies were significantly more common in the mothers of children with cerebral palsy, where no significant differences were found between the groups in terms of breech delivery, rate of cesarean births, gestational diabetes, and hemorrhage in late pregnancy. Birth asphyxia, liqueur with meconium stained, prolonged jaundice and neonatal seizure were also significantly more common in the group with cerebral palsy. Of the children with cerebral palsy, 78% were born at term, 20% were born with gestational ages of 32-36 weeks, 2% were born with gestational ages of 30-31 weeks. Nine percent of those children had a birth weight of >or= 3000 g, 12.2% had a birth weight of 2500-2999 g, 33.7% had a birth weight of 1500-2499 g, and 5.1% had a birth weight of 相似文献   

Longitudinal Predictors of Psychiatric Disorders in Very Low Birth Weight Adults

The purpose of this study was to determine risk and protective factors for adult psychiatric disorders in very low birth weight (VLBW, birth weight <1,501 g) survivors. 79 of 154 (51%) VLBW subjects recruited at birth were assessed in early adulthood (24–27 years). Participants were screened for a psychiatric disorder; those elevated were invited to attend a structured clinical interview to determine a clinical diagnosis. Longitudinal variables measured from birth and at ages 2, 5, 14 and 18 years were included in analyses. Perinatal, developmental and social environmental risk factors failed to predict psychiatric disorder in adulthood in this cohort of VLBW survivors. Instead, low self-esteem at age 18 (odds ratio [OR] = 1.05, 95% confidence interval [CI] = 1, 1.11, p = 0.05) and the adult social environment (high rates of negative life event stress at the time of assessment: OR = 1.39, CI = 1.10, 1.76, p = 0.02), contributed significantly to adult psychiatric outcomes.     

Developmental status of 5-year-old moderate low birth weight children

Background: Low birth weight (LBW or birth weight < 2500 g) is one of the most serious children problems in today’s world. The purpose of this study was to evaluate and compare developmental status of moderately LBW (birth weight: 1500-2499 g) children at the age of five to that of normal birth weight (NBW: birth weight: 2500-4000 g) ones. Methods: In a case-control study, developmental status of five year old children referred for vaccination between December 2008 and June 2009 in Yazd-Iran, evaluated via Persian version of 60-month Ages and Stages Questionnaires (ASQ). NBW and MLBW children were selected as control and case groups, respectively. Results: Frequency of developmental delay in gross motor, fine motor and problem solving domains were significantly higher in MLBW group and mean score in all developmental domains was statistically significant lower in case group. Conclusion: LBW is one of risk factors for developmental delay. So, evaluation and monitoring of development status of LBW should be emphasized for early and timely diagnosis, investigation, management and also rehabilitation.     

Mental and motor development at 24 months of full-term low birthweight infants

The objective of this study was to compare the development at 24 months of 152 full-term infants, born with low (<2500g) and appropriate birth weight (3000 to 3499g), paired in a proportion of 1:1 by sex and age. Mental and motor development were assessed through the Bayley scale. A variety of sociodemographic and environmental stimulation conditions were also assessed. The infants born with low weight had on average significantly lower mental and motor indexes than those born with appropriate weight (p<0.001), with a difference of 9.1 and 10.2 points, respectively. The multiple linear regression analysis showed that socioeconomic conditions and environmental stimulation explained 11% and 12% of the variation of mental index, and 12% and 9% of motor development, respectively. All together, they explained 23% and 21% of the variation of these indexes. Low birth weight influenced only 3% of the variation of mental index and 5% of motor index.     

Precursors of mental health problems for low birth weight children: the salience of family environment during the first year of life

The purpose of this study was to determine the contributions of infant characteristics and early family environment to the incidence of emotional and behavioral problems for low birth weight children. Data were collected from ethnically diverse families of 110 children who had a birth weight of less than 2500 grams. Results of stepwise regression analysis indicated that inadequate family income, troubles with family cohesion and adaptability, and an infant's insecure attachment to the mother accounted for 48% of the variance in the incidence of emotional-behavioral problems for children. None of the infants' characteristics, including birth weight, perinatal morbidity, cognitive ability and social competence, entered the regression model. Findings suggest that family environment is a key factor in the low birth weight child's risk for early mental health problems.     

A prospective twin study of birth weight discordance and child problem behavior.

BACKGROUND: We investigated whether low birth weight constitutes a causal risk factor for child problem behavior, using a variation of the co-twin control method. METHODS: In a representative sample of 745 twin pairs (monozygotic: 324 pairs), birth weight was recorded at birth and child problem behavior at mean age 10 years was measured with the Child Behaviour Checklist (CBCL). RESULTS: Lower birth weight was a continuous risk factor for later child problem behavior (adjusted regression coefficient over units of 500 g: beta = -.15, p =.046), and greater levels of within-pair CBCL discordance did not result in a reduced effect size. Greater within-pair birth weight discordance was associated with greater within-pair CBCL score discordance (beta =.35, p <.001). This latter effect was similar in monozygotic (beta =.34, p =.005) and dizygotic twins (beta =.37, p =.003). CONCLUSIONS: The fact that (1) the effect size of the association between low birth weight and child problem behavior was not reduced in pairs with greater levels of CBCL discordance, and (2) similar effect sizes were found in monozygotic and dizygotic twins for the within-pair association between birth weight discordance and CBCL score discordance, suggests that the observed relationship between low birth weight and child problem behavior is not due to a shared environmental or genetic variable that influences both characteristics. Lower birth weight is a causal risk factor for child problem behavior, the effects of which may well extend into adulthood.     

Perinatal profile of very low birthweight infants under a universal newborn hearing screening programme in a developing country: A case-control study

Objective: To determine the perinatal profile and developmental risks of very low birth weight (VLBW) infants (≤1500 g) under a universal hearing screening programme in a resource-poor country.

Methods: A case-control study of VLBW survivors matched by date of birth and sex with normal birth weight (≥2500 g) infants delivered in an inner-city maternity hospital in Lagos, Nigeria. Hearing status was determined by two-stage screening with transient evoked otoacoustic emissions (TEOAE) followed by automated auditory brainstem response (AABR). Maternal and infant factors associated with VLBW were determined using unconditional and conditional multivariable logistic regression analyses.

Results: All 45 VLBW singletons (mean weight 1.3 ± 0.1 kg) during the study period were matched with 225 controls (mean weight 3.4 ± 0.5 kg). VLBW was associated with maternal occupation, lack of antenatal care, low 5-minute Apgar score and hyperbilirubinemia based on unmatched and matched analyses. Additionally, VLBW infants were significantly associated with failed or incomplete hearing screening outcomes. Four (10.5%) of the 38 infants tested with AABR failed, but none returned for diagnostic evaluation and one child had previously passed TEOAE.

Conclusions: VLBW infants in resource-poor settings are associated with the risk of sensorineural hearing loss and other perinatal outcomes that may potentially compromise their optimal development in early childhood.