社区老年人无症状性大脑中动脉狭窄的患病率及危险因素研究

目的探讨社区老年人无症状性大脑中动脉(MCA)狭窄的患病率和危险因素。方法用经颅多普勒超声(TCD)评价MCA狭窄,并详细记录其性别、年龄,高血压、糖尿病、血脂异常等病史和脑卒中家族史,以及吸烟、饮酒情况;并进行血压、体质量、身高和腰围的测量;对MCA狭窄组和性别、年龄相匹配的无MCA狭窄的对照组检测血脂、血糖和同型半胱氨酸。结果 577人符合入选标准,年龄60～90岁,男243人(42.11%),女334人(57.89%)。无症状性MCA狭窄的患病率为8.7%(50/577),其中,男性患病率为9.1%(22/243),女性为8.4%(28/334),男女患病率比较,差异无统计学意义(P>0.05);60～69岁患病率为6.3%(22/347),≥70岁患病率为12.2%(28/230),两者比较差异有统计学意义(P=0.015)。无症状性MCA狭窄与年龄有正关联,OR值为2.048,95%CI(1.140,3.677)。狭窄组高血压的患病率高于对照组(P=0.037),且收缩压增高率亦高于对照组(P=0.005);而两组的舒张压增高率比较,差异无统计学意义(P>0.05)。无症状性MCA狭窄与高血压病史〔OR=2.005,95%CI(1.036,3.881)〕和收缩压增高〔OR=2.538,95%CI(1.315,4.897)〕有正关联。两组在其他血管危险因素方面差异均无统计学意义(P>0.05)。结论北京市朝阳区社区老年人无症状性MCA狭窄的患病率为8.7%,年龄和高血压可能是其危险因素。

Study of Asymptomatic Middle Cerebral Artery Stenosis Prevalence and Risk Factors of Elderly People

Objective To investigate the prevalence rate and risk factors of the asymptomatic middle cerebral artery(MCA) stenosis of the community-dwelling elderly people.Methods The transcranial Doppler sonography(TCD) was used to assess MCA stenosis.The personal information such as sex,ages,history of illnesses such as hypertension,diabetes mellitus,dyslipidemia,and family history of stroke,as well as participants′ smoking,drinking problems were recorded in detail.The physical examination was undergone to got blood pressure,weight,height and waistline.The serum level of blood lipid,glucose and homocysteine(Hcy) was measured in both a stenosis group and a control group matched in age and sex.Results 577 participants met the inclusion criteria,including 243 male(42.11%),334 female(57.89%) both during 60 ~ 90 years old.The prevalence of the asymptomatic MCA stenosis was 8.7%(50/577),of which,9.1%(22/243)in male,8.4%(28/334) in females,no statistical significance in difference of the prevalence between the male and female(P>0.05);6.3%(22/347) during 60 ~ 69 years old,12.2%(28/230) over 70 years of age,and the statistical significance in difference was found(P=0.015).The positive correlation was found between asymptomatic MCA stenosis and age(OR=2.048,95%CI(1.140,3.677)).The prevalence of hypertension(P=0.037),systolic blood pressure(P=0.005) of a stenosis group were significantly higher than that of a control group,while no statistical significance in difference of the prevalence of high diastolic pressure was found in the two groups(P>0.05).The positive correlation was found in both asymptomatic MCA stenosis and hypertension history(OR=2.005,95%CI(1.036,3.881)),and systolic pressure(OR=2.538,95%CI(1.315,4.897)).There were no statistical significance within two groups in other vascular risk factors(P>0.05).Conclusion The prevalence of the asymptomatic MCA stenosis is 8.7% in the community-dwelling elderly people at Chaoyang District,Beijing City,and the age and hypertension may be the risk factors.