【摘要】：目的建立高血壓患者并發(fā)腦卒中的風(fēng)險(xiǎn)評(píng)估模型。方法通過(guò)Meta分析的方法獲得高血壓患者并發(fā)腦卒中的危險(xiǎn)因素及相應(yīng)的合并風(fēng)險(xiǎn)值,構(gòu)建Rothman-Keller模型的危險(xiǎn)評(píng)分表,再通過(guò)二項(xiàng)分布函數(shù)方法生成一組隨機(jī)數(shù)據(jù)集,確定風(fēng)險(xiǎn)評(píng)估等級(jí)劃分界值,并采用實(shí)際數(shù)據(jù)驗(yàn)證。結(jié)果共納入31篇文獻(xiàn),進(jìn)入Rothman-Keller模型的因素包括收縮壓、舒張壓、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、同型半胱氨酸、高尿酸血癥、空腹血糖受損/糖尿病、腦卒中家族史、頸動(dòng)脈斑塊、是否規(guī)律服藥、體育鍛煉、吸煙。實(shí)際人群發(fā)病情況與模型預(yù)測(cè)結(jié)果的ROC曲線下面積及95%CI為0.784(0.718,0.849),P0.001。結(jié)論本模型的預(yù)測(cè)效果較好,可以應(yīng)用于高血壓患者并發(fā)腦卒中的一級(jí)預(yù)防,有助于降低高血壓患者并發(fā)腦卒中的風(fēng)險(xiǎn)。
[Abstract]:Objective to establish a risk assessment model for cerebral apoplexy in patients with hypertension. Methods the risk factors and associated risk values of stroke in hypertensive patients were obtained by Meta analysis. The risk score table of Rothman-Keller model was constructed, and then a set of random data sets was generated by binomial distribution function method. The boundary value of risk assessment level is determined and verified by actual data. Results the factors involved in the Rothman-Keller model included systolic blood pressure, diastolic blood pressure, high density lipoprotein cholesterol, low density lipoprotein cholesterol, homocysteine, hyperuricemia, impaired fasting blood glucose / diabetes mellitus. Stroke family history, carotid plaque, regular medication, physical exercise, smoking. The area under ROC curve and 95%CI were 0.784 (0.718, 0.849), P0.001.The area under the curve of the actual population and the predicted results of the model were 0.784 (0.718, 0.849). Conclusion the prediction effect of this model is good, it can be used in primary prevention of hypertensive patients with cerebral apoplexy, and it is helpful to reduce the risk of stroke in hypertensive patients.
【作者單位】： 第三軍醫(yī)大學(xué)軍事預(yù)防醫(yī)學(xué)院衛(wèi)生統(tǒng)計(jì)學(xué)教研室;第三軍醫(yī)大學(xué)大坪醫(yī)院野戰(zhàn)外科研究所第九研究室;
【基金】：國(guó)家自然科學(xué)基金面上項(xiàng)目(81473068,81202286)~~
【分類(lèi)號(hào)】：O213;R544.1;R743.3
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本文編號(hào)：2435035