内蒙古地区居民脑出血发病影响因素分析

田梓璇; 韩乐; 闫涛; 苗宇; 郭淑怡; 张楠; 张星光

doi:10.16462/j.cnki.zhjbkz.2023.06.008

内蒙古地区居民脑出血发病影响因素分析

doi: 10.16462/j.cnki.zhjbkz.2023.06.008

田梓璇¹,
韩乐²,
闫涛¹,
苗宇¹,
郭淑怡⁴,
张楠^3, ,,
张星光^1, ,

1.
内蒙古医科大学公共卫生学院卫生统计学教研室, 呼和浩特 010110
2.
呼和浩特市疾病预防控制中心鼠疫布病防制所, 呼和浩特 010110
3.
内蒙古医科大学公共卫生学院卫生毒理学教研室, 呼和浩特 010110
4.
内蒙古自治区人民医院应急管理科, 呼和浩特 010110

基金项目:

国家自然科学基金 82160639

内蒙古自治区高等学校青年科技英才支持计划 NJYT22008

内蒙古自治区卫生健康科技计划 202201227

详细信息

通讯作者:
张楠，E-mail: 17704713193@163.com

张星光，E-mail: zxg311@126.com

中图分类号: R743.34
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- 文章访问数: 85
- HTML全文浏览量: 62
- PDF下载量: 12
- 被引次数: 0
出版历程
- 收稿日期: 2022-10-01
- 修回日期: 2023-01-14
- 网络出版日期: 2023-07-10
- 刊出日期: 2023-06-10

Influencing factors of cerebral hemorrhage among residents in Inner Mongolia

TIAN Zixuan¹,
HAN Le²,
YAN Tao¹,
MIAO Yu¹,
GUO Shuyi⁴,
ZHANG Nan^{3
, ,},
ZHANG Xingguang^{1
, ,}

1.
Department of Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot 010110, China
2.
Plague and Brucellosis Control Office, Hohhot Center for Disease Control and Prevention, Hohhot 010110, China
3.
Department of Toxicology, School of Public Health, Inner Mongolia Medical University, Hohhot 010110, China
4.
Emergency Management Department, People′s Hospital of Inner Mongolia Autonomous Region, Hohhot 010110, China

Funds:

National Natural Science Foundation of China 82160639

Young Talents of Science and Technology in Universities of Inner Mongolia Autonomous Region NJYT22008

Inner Mongolia Health Science and Technology 202201227

More Information

Corresponding author: ZHANG Nan, E-mail: 17704713193@163.com; ZHANG Xingguang, E-mail: zxg311@126.com

摘要

摘要: 目的通过了解内蒙古地区不同特征居民的脑出血(intracerebral hemorrhage, ICH)发病情况, 分析ICH发病的影响因素, 为制定内蒙古地区居民ICH的预防措施提供科学依据。方法采用多阶段分层整群抽样抽取6个城市(盟市)建立队列研究人群, 随访数据取自2015年12月1日-2021年12月31日, 随访内容包括一般情况、疾病史及治疗史、体格检查和实验室检测。采用单因素和多因素Cox回归分析性别、年龄、血压等因素与ICH发病的关联。结果共纳入36 367名研究对象, 随访期间首发ICH事件共计385例(1.05%)。多因素Cox回归分析显示: 年龄增加(HR>1.000, P < 0.05)、蒙古族(HR=1.768, P < 0.05)和高血压(HR=1.492, P < 0.05)为ICH发病的危险因素; 女性(HR=0.434, P < 0.05)和高教育水平(HR < 1.000, P < 0.05)为ICH发病的保护因素。结论在内蒙古地区, 男性、年龄增加、高血压、低教育水平、蒙古族与ICH发病风险相关。
- 脑出血 /
- 影响因素 /
- 队列研究 /
- 内蒙古地区
Abstract: Objective To elucidate the incidence of intracerebral hemorrhage (ICH) among residents of different demographics in Inner Mongolia and analyze the influencing factors, thereby providing a scientific basis for the prevention of ICH in this region. Methods Multi-stage stratified cluster sampling was used to establish a study population from six cities.Follow-up data were collected from December 1, 2015, to December 31, 2021, encompassing general information, medical history, treatment history, physical examination, and laboratory tests.Univariate and multivariate Cox regression analyses were utilized to examine the correlation of sex, age, and blood pressure with ICH incidence. Results The study comprised 36 367 participants, among which 385 cases (1.05%) of initial ICH were recorded during the follow-up period.Multivariate Cox regression analysis identified increasing age (HR>1.000, P < 0.05), Mongolian ethnicity (HR=1.768, P < 0.05), and hypertension (HR=1.492, P < 0.05) as risk factors for ICH onset.In contrast, being female (HR=0.434, P < 0.05) and having a higher education level (HR < 1.000, P < 0.05) emerged as protective factors. Conclusions In Inner Mongolia, the risk of ICH is closely associated with certain factors, including being male, advancing age, hypertension, low education level, and Mongolian ethnicity.This study underscores the importance of targeted interventions to prevent ICH in populations at risk in this region.
- Intracerebral hemorrhage /
- Influencing factors /
- Cohort study /
- Inner Mongolia

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表 1 研究对象基本特征[例数(占比/%)]

Table 1. Baseline characteristics of the participants (population/%)

变量	合计	女性	男性
年龄组/岁
35~ < 45	3 619(9.95)	1 793(49.54)	1 826(50.46)
45~ < 55	10 676(29.36)	6 064(56.80)	4 612(43.20)
55~ < 65	13 914(38.26)	8 016(57.61)	5 898(42.39)
≥65~75	8 158(22.43)	4 463(54.71)	3 695(45.29)
民族
汉族	32 844(90.31)	18 404(56.03)	14 440(43.97)
蒙古族	2 894(7.96)	1 590(54.94)	1 304(45.06)
其他	629(1.73)	342(54.37)	287(45.63)
教育水平
未上学或小学肄业	6 675(18.35)	5 239(78.49)	1 436(21.51)
小学	7 718(21.22)	4 603(59.64)	3 115(40.36)
初中	10 943(30.10)	5 563(50.84)	5 380(49.16)
高中或中专	7 002(19.25)	3 334(47.61)	3 668(52.39)
大学及以上	4 029(11.08)	1 597(39.64)	2 432(60.36)
吸烟	9 294(25.56)	1 413(15.20)	7 881(84.80)
饮酒	4 358(11.98)	320(7.34)	4 038(92.66)
高血压	18 406(50.62)	10 573(57.40)	7 833(42.60)
糖尿病	8 828(24.27)	4 636(52.51)	4 192(47.49)
BMI/(kg·m^-2) ^①	26.35±3.48	26.29±3.55	26.44±3.40
SBP/mmHg ^①	155.73±22.56	157.02±23.03	154.10±21.83
DBP/mmHg ^①	91.27±12.93	89.82±12.83	93.10±12.83
TG/(mmol·L^-1) ^②	1.55(1.10, 2.25)	1.60(1.14, 2.28)	1.48(1.04, 2.21)
HDL-C/(mmol·L^-1) ^②	1.30(1.07, 1.58)	1.39(1.17, 1.66)	1.18(0.97, 1.45)
LDL-C/(mmol·L^-1) ^②	2.55(1.93, 3.05)	2.57(2.03, 3.23)	2.40(1.81, 2.82)
注：1. TG：三酰甘油。2. HDL-C：高密度脂蛋白胆固醇。3. LDL-C：低密度脂蛋白胆固醇。 ①使用(x ±s)表示。②使用[M(P₂₅, P₇₅)]表示。

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表 2 不同特征研究对象ICH发病情况

Table 2. Incidence of ICH in study populations with different characteristics

变量	ICH/例数(占比/%)	未发生ICH/例数(占比/%)	人年发病率/10万人年^-1	$ \chi^2$值	P值
年龄组/岁				37.147	＜0.001
35~ < 45	7(0.20)	3 612(99.80)	55.99
45~ < 55	96(0.90)	10 580(99.10)	283.85
55~ < 65	166(1.18)	13 748(98.82)	388.46
≥65~75	116(1.42)	8 042(98.58)	501.18
性别				34.952	＜0.001
女	158(0.78)	20 178(99.22)	250.64
男	227(1.40)	15 084(98.60)	467.90
民族				10.016	0.007
汉族	330(1.00)	32 514(99.00)	326.45
蒙古族	47(1.62)	2 847(98.38)	542.97
其他	8(1.27)	621(98.73)	438.79
教育水平				52.479	＜0.001
未上学或小学肄业	107(1.60)	6 568(98.40)	516.29
小学	110(1.43)	7 608(98.57)	425.06
初中	93(0.85)	10 850(99.15)	293.78
高中或中专	58(0.83)	6 944(99.17)	275.70
大学及以上	17(0.42)	4 012(99.58)	138.55
吸烟				5.306	0.021
是	118(1.27)	9 176(98.73)	420.72
否	267(0.99)	26 806(99.01)	319.69
饮酒				10.835	0.001
是	67(1.54)	4 291(98.46)	478.45
否	318(0.99)	31 691(99.01)	325.94
高血压				15.078	＜0.001
是	272(1.15)	18 134(98.85)	376.42
否	113(0.61)	17 848(99.39)	198.54
糖尿病				0.179	0.672
是	97(1.10)	8 731(98.90)	347.67
否	288(1.05)	27 251(98.95)	344.23
注：1. ICH：脑出血。

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表 3 ICH发病的影响因素分析

Table 3. Factors on the incidence of ICH

变量	单因素Cox回归			多因素Cox回归
变量	HR值	95% CI	P值	HR值	95% CI	P值
年龄组/岁
35~ < 45	1.000			1.000
45~ < 55	4.844	2.249~10.435	< 0.001	4.489	2.080~9.688	< 0.001
55~ < 65	6.674	3.133~14.217	< 0.001	5.401	2.522~11.568	< 0.001
≥65~75	8.722	4.067~18.704	< 0.001	6.221	2.876~13.456	< 0.001
性别
男	1.000			1.000
女	0.533	0.435~0.653	< 0.001	0.434	0.349~0.540	< 0.001
民族
汉族	1.000			1.000
蒙古族	1.684	1.240~2.286	0.001	1.768	1.299~2.405	< 0.001
其他	1.371	0.680~2.765	0.378	1.562	0.774~3.155	0.213
教育水平
未上学或小学肄业	1.000			1.000
小学	0.818	0.627~1.067	0.139	0.719	0.547~0.947	0.019
初中	0.581	0.440~0.767	< 0.001	0.519	0.387~0.696	< 0.001
高中或中专	0.544	0.395~0.749	< 0.001	0.470	0.335~0.659	< 0.001
大学及以上	0.273	0.164~0.456	< 0.001	0.254	0.149~0.433	< 0.001
是否吸烟
否	1.000
是	1.320	1.063~1.639	0.012
是否饮酒
否	1.000
是	1.435	1.103~1.868	0.007
是否高血压
否	1.000			1.000
是	1.879	1.349~2.616	< 0.001	1.492	1.068~2.084	0.019
是否糖尿病
否	1.000
是	1.002	0.796~1.261	0.988
BMI/(kg·m^-2)	0.988	0.960~1.016	0.390
LDL-C/(mmol·L^-1)
< 1.93	1.000
1.93~ < 2.55	0.959	0.726~1.266	0.758
2.55~ < 3.05	0.943	0.710~1.253	0.687
≥3.05	0.877	0.659~1.166	0.367
HDL-C/(mmol·L^-1)
< 1.07	1.000			1.000
1.07~ < 1.30	0.778	0.581~1.041	0.092	0.793	0.590~1.064	0.122
1.30~ < 1.58	0.728	0.542~0.978	0.035	0.746	0.522~1.009	0.057
≥1.58	1.061	0.818~1.375	0.657	1.059	0.809~1.387	0.677
TG/(mmol·L^-1)
< 1.10	1.000
1.10~ < 1.55	0.879	0.679~1.137	0.325
1.55~ < 2.25	0.683	0.516~0.904	0.008
≥2.25	0.693	0.520~0.924	0.012
注：1. ICH：脑出血。2. TG：三酰甘油。3. HDL-C：高密度脂蛋白胆固醇。4. LDL-C：低密度脂蛋白胆固醇。5. LDL-C、HDL-C、TG等数值指标以中位数和四分位数分组。

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变量	合计	女性	男性
年龄组/岁
35~ < 45	3 619(9.95)	1 793(49.54)	1 826(50.46)
45~ < 55	10 676(29.36)	6 064(56.80)	4 612(43.20)
55~ < 65	13 914(38.26)	8 016(57.61)	5 898(42.39)
≥65~75	8 158(22.43)	4 463(54.71)	3 695(45.29)
民族
汉族	32 844(90.31)	18 404(56.03)	14 440(43.97)
蒙古族	2 894(7.96)	1 590(54.94)	1 304(45.06)
其他	629(1.73)	342(54.37)	287(45.63)
教育水平
未上学或小学肄业	6 675(18.35)	5 239(78.49)	1 436(21.51)
小学	7 718(21.22)	4 603(59.64)	3 115(40.36)
初中	10 943(30.10)	5 563(50.84)	5 380(49.16)
高中或中专	7 002(19.25)	3 334(47.61)	3 668(52.39)
大学及以上	4 029(11.08)	1 597(39.64)	2 432(60.36)
吸烟	9 294(25.56)	1 413(15.20)	7 881(84.80)
饮酒	4 358(11.98)	320(7.34)	4 038(92.66)
高血压	18 406(50.62)	10 573(57.40)	7 833(42.60)
糖尿病	8 828(24.27)	4 636(52.51)	4 192(47.49)
BMI/(kg·m^-2) ^①	26.35±3.48	26.29±3.55	26.44±3.40
SBP/mmHg ^①	155.73±22.56	157.02±23.03	154.10±21.83
DBP/mmHg ^①	91.27±12.93	89.82±12.83	93.10±12.83
TG/(mmol·L^-1) ^②	1.55(1.10, 2.25)	1.60(1.14, 2.28)	1.48(1.04, 2.21)
HDL-C/(mmol·L^-1) ^②	1.30(1.07, 1.58)	1.39(1.17, 1.66)	1.18(0.97, 1.45)
LDL-C/(mmol·L^-1) ^②	2.55(1.93, 3.05)	2.57(2.03, 3.23)	2.40(1.81, 2.82)
注：1. TG：三酰甘油。2. HDL-C：高密度脂蛋白胆固醇。3. LDL-C：低密度脂蛋白胆固醇。 ①使用(x ±s)表示。②使用[M(P₂₅, P₇₅)]表示。

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内蒙古地区居民脑出血发病影响因素分析

doi: 10.16462/j.cnki.zhjbkz.2023.06.008

通讯作者:
张楠，E-mail: 17704713193@163.com

张星光，E-mail: zxg311@126.com

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Influencing factors of cerebral hemorrhage among residents in Inner Mongolia

Corresponding author: ZHANG Nan, E-mail: 17704713193@163.com; ZHANG Xingguang, E-mail: zxg311@126.com

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留言板

内蒙古地区居民脑出血发病影响因素分析

doi: 10.16462/j.cnki.zhjbkz.2023.06.008

通讯作者: 张楠，E-mail: 17704713193@163.com 张星光，E-mail: zxg311@126.com

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Influencing factors of cerebral hemorrhage among residents in Inner Mongolia

Corresponding author: ZHANG Nan, E-mail: 17704713193@163.com; ZHANG Xingguang, E-mail: zxg311@126.com

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出版历程

目录

通讯作者:
张楠，E-mail: 17704713193@163.com

张星光，E-mail: zxg311@126.com