45-74岁男性和女性缺血性中风的危险因素

M. Maksimova, V. Y. Sazonova
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摘要

中风是导致死亡和主要残疾的主要原因之一,是造成全球疾病负担的重要因素。识别缺血性脑卒中高危人群是疾病预防的重要组成部分。男性和女性中风的危险因素(RF)之间的差异尚不清楚。目的:探讨RF对45-74岁男性和女性IS发展的预测价值。材料和方法。研究纳入728例患者(男性380例,女性348例),年龄45-74岁,其中颈动脉盆区IS患者392例(男性247例,女性145例)(主组),血管性认知障碍患者336例(男性133例,女性203例)(对照组)。为了建立预测模型来评估RF对男性和女性IS发展的影响,我们使用了根据Wald算法逐步排除变量的逻辑回归方法。男性IS的预测回归模型包括颈内动脉粥样硬化性狭窄[优势比(OR) 3.571;95%置信区间(CI) 1.792-7.114),在女性预测回归模型中- 2型糖尿病(OR 5.074;95% CI 1.768-14.561)和IS病史(OR 6.857;95% ci 1.825-25.762)。其他IS发展的危险因素(心房颤动、短暂性脑缺血发作史、动脉高血压期)对男性和女性都有影响。研究发现,颈内动脉粥样硬化性狭窄是男性IS和女性2型糖尿病和IS病史的一个性别特异性预后因素。
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Risk factors for ischemic stroke in men and women aged 45–74 years
Stroke is one of the leading causes of death and primary disability and contributes significantly to the global burden of disease. Identification of individuals at high risk of ischemic stroke (IS) is an important component of disease prevention. The differences between risk factors (RF) for stroke in men and women are not well understood.Objective: to determine the predictive value of RF for the development of IS in men and women aged 45–74 years.Material and methods. The study included 728 patients (380 men and 348 women) aged 45–74 years, including 392 patients (247 men and 145 women) with IS in the carotid artery basin (main group) and 336 patients (133 men and 203 women) with vascular cognitive impairment (comparison group). To build predictive models to assess the impact of RF on the development of IS in men and women, we used the logistic regression method with stepwise exclusion of variables according to the Wald algorithm.Results. The predictive regression model of IS in men includes atherosclerotic stenosis of the internal carotid arteries [odds ratio (OR) 3.571; 95% confidence interval (CI) 1.792–7.114], in a predictive regression model in women – diabetes mellitus type 2 (OR 5.074; 95% CI 1.768–14.561) and a history of IS (OR 6.857; 95% CI 1.825–25.762). Other risk factors for the development of IS (atrial fibrillation, history of transient ischemic attack, arterial hypertension stage) affected both men and women.Conclusion. Atherosclerotic stenosis of the internal carotid arteries was found to be a sex-specific prognostic factor for IS in men, and type 2 diabetes mellitus and a history of IS in women.
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