吸煙指數(shù)與腦血管狹窄程度及部位相關(guān)性研究
發(fā)布時(shí)間：2019-07-05 05:21
【摘要】：背景缺血性腦血管病(Ischemic Cerebrovascular Disease,ICVD)有高發(fā)病率、高復(fù)發(fā)率、危害性大[1]等特點(diǎn),是導(dǎo)致殘疾的主要危險(xiǎn)因素。近來吸煙與ICVD的關(guān)系越來越受到重視,雖然吸煙導(dǎo)致ICVD和動脈粥樣硬化的確切機(jī)制尚不完全明了,但吸煙已被確認(rèn)為腦梗死發(fā)病的獨(dú)立危險(xiǎn)因素之一。吸煙指數(shù)等于吸煙支數(shù)/天×吸煙年數(shù),因此通過研究吸煙指數(shù)與ICVD腦血管狹窄程度及部位的關(guān)系,可量化吸煙與腦血管狹窄的關(guān)系,為更有效的防治ICVD提供理論基礎(chǔ)。目的通過研究吸煙指數(shù)與ICVD腦血管狹窄程度及部位相關(guān)性,量化吸煙與腦血管狹窄的關(guān)系,為更有效的防治ICVD提供理論基礎(chǔ)。方法選取2011年1月-2016年12月之間在大連市中心醫(yī)院住院治療的ICVD患者,收集樣本(病例)相關(guān)資料,包括年齡、性別、每日吸煙支數(shù)、吸煙年數(shù)、高脂血癥、高血壓、糖尿病、高同型半胱氨酸血癥(Hyperhomocysteinemia,Hcy)、飲酒、血管狹窄程度及部位等,最終納入吸煙并發(fā)高血壓高脂血癥的男性患者207例,依據(jù)頭頸部CTA報(bào)告分別記錄每名患者血管狹窄程度及部位,分別比較分析各組不同血管狹窄程度之間在年齡、吸煙年數(shù)、每日吸煙支數(shù)、吸煙指數(shù)等因素上差異有無統(tǒng)計(jì)學(xué)意義,使用統(tǒng)計(jì)軟件SPSS 21.0 for Windows作統(tǒng)計(jì)學(xué)處理,P0.05為差異有統(tǒng)計(jì)學(xué)意義,并用多元逐步線性回歸進(jìn)一步分析各因素與血管狹窄程度的相關(guān)性。結(jié)果1.腦血管狹窄組輕度狹窄組76例,中度狹窄組25例,重度狹窄組45例,閉塞組61例。各組之間在年齡、吸煙年數(shù)、吸煙支數(shù)、吸煙指數(shù)、飲酒、Hcy上差異無統(tǒng)計(jì)學(xué)意義。2.按腦血流動脈供應(yīng)系統(tǒng)分為前循環(huán)組和后循環(huán)組(1)前循環(huán)血管狹窄組前循環(huán)無狹窄組7例,輕度狹窄組111例,中度狹窄組26例,重度狹窄組18例,閉塞組45例。各組之間在年齡、吸煙年數(shù)、吸煙支數(shù)、吸煙指數(shù)、飲酒、hcy上差異無統(tǒng)計(jì)學(xué)意義。(2)后循環(huán)血管狹窄組1)后循環(huán)無狹窄組61例,輕度狹窄組60例,中度狹窄組22例,重度狹窄組45例,閉塞組19例。各組之間在吸煙年數(shù)上差異有統(tǒng)計(jì)學(xué)意義。各組之間在年齡、吸煙支數(shù)、吸煙指數(shù)、飲酒、hcy上差異無統(tǒng)計(jì)學(xué)意義。2)多元逐步線性回歸分析:以a=0.05水平為界,最后吸煙年數(shù)可進(jìn)入回歸模型,并且后循環(huán)血管狹窄程度與吸煙年數(shù)呈正相關(guān)關(guān)系(b=0.256)。3.按腦血管狹窄部位分為顱內(nèi)組和顱外組(1)顱內(nèi)血管狹窄組1)顱內(nèi)無狹窄組17例,輕度狹窄組74例,中度狹窄組26例,重度狹窄組34例,閉塞組56例。各組之間在吸煙指數(shù)上差異有統(tǒng)計(jì)學(xué)意義,各組之間在年齡、吸煙年數(shù)、吸煙支數(shù)、飲酒、hcy上差異無統(tǒng)計(jì)學(xué)意義。2)多元逐步線性回歸分析:將吸煙指數(shù)進(jìn)行多元逐步線性回歸分析,以a=0.05水平為界,最后吸煙指數(shù)不可進(jìn)入回歸模型,說明顱內(nèi)血管狹窄程度與吸煙指數(shù)不呈線性相關(guān)關(guān)系。(2)顱外血管狹窄組1)顱外無狹窄組14例,輕度狹窄組121例,中度狹窄組20例,重度狹窄組26例,閉塞組26例。各組之間在吸煙年數(shù)、吸煙指數(shù)上差異有統(tǒng)計(jì)學(xué)意義。各組之間在年齡、吸煙支數(shù)、飲酒、hcy上差異無統(tǒng)計(jì)學(xué)意義。2)多元逐步線性回歸分析:將上述2個(gè)因素進(jìn)行多元逐步線性回歸分析,以a=0.05水平為界,最后吸煙指數(shù)可進(jìn)入回歸模型,并且顱外血管狹窄程度與吸煙指數(shù)呈正相關(guān)關(guān)系(b=0.278)。結(jié)論1.腦血管狹窄程度與吸煙指數(shù)未見相關(guān)性。2.后循環(huán)血管狹窄程度與吸煙指數(shù)未見相關(guān)性;后循環(huán)血管狹窄程度與吸煙年數(shù)呈正相關(guān)關(guān)系,吸煙年數(shù)越長,后循環(huán)血管狹窄程度越重;前循環(huán)血管狹窄程度與吸煙指數(shù)未見相關(guān)性。3.顱外血管狹窄程度與吸煙指數(shù)呈正相關(guān)關(guān)系,吸煙指數(shù)越大,顱外血管狹窄程度越重;顱內(nèi)血管狹窄程度與吸煙指數(shù)未見相關(guān)性。
[Abstract]:Background Ischemic Cerebrovascular Disease (ICVD) has the characteristics of high incidence, high recurrence rate, and great harm[1], which is the main risk factor leading to disability. Recently, the relationship between smoking and ICVD is becoming more and more important, although the exact mechanism of smoking leading to ICVD and atherosclerosis is not completely clear, smoking has been identified as one of the independent risk factors for the onset of cerebral infarction. The smoking index is equal to the number of smokers per day and the number of years of smoking. Therefore, by studying the relationship between the smoking index and the degree and location of the cerebrovascular stenosis of the ICVD, the relationship between smoking and cerebrovascular stenosis can be quantified, and the theoretical basis for more effective prevention and control of ICVD is provided. Objective To study the relationship between smoking index and the degree of cerebral stenosis of ICVD, to quantify the relationship between smoking and cerebrovascular stenosis, and to provide a theoretical basis for more effective prevention and treatment of ICVD. Methods The patients with ICVD in the Central Hospital of Dalian were selected from January 2011 to December 2016, and the relevant data of the samples (cases) were collected, including age, sex, daily smoking count, number of years of smoking, hyperlipidemia, hypertension, diabetes, hyperhomocysteinemia (Hyperhomocysteinmia, etc.). "Hcy), alcohol consumption, degree of blood vessel stenosis and location, etc., were included in 207 male patients with hypertension and hyperlipidemia, respectively, and the degree of blood vessel stenosis and the location of each patient were recorded according to the report of the head and neck CTA, respectively, and the age between the different degree of stenosis of each group was compared and analyzed, respectively. There was no significant difference in the number of years of smoking, the number of cigarette smoking, the smoking index and other factors. The statistical software was used for statistical treatment with SPSS 21.0 for Windows. The difference was statistically significant, and the correlation between the factors and the degree of stenosis was further analyzed by the stepwise linear regression. Results 1. There were 76 cases of mild stenosis group,25 cases of moderate stenosis group,45 cases of severe stenosis group and 61 cases of occlusion group. There was no significant difference in age, number of years of smoking, number of smoking, smoking index, alcohol consumption and Hcy. According to the cerebral blood flow artery supply system, there were 7 cases with no stenosis group,111 cases of mild stenosis group,26 cases of moderate stenosis group,18 cases of severe stenosis group and 45 cases of occlusion group. There was no significant difference in age, number of years of smoking, number of smoking, smoking index, alcohol consumption and hcy among the groups. (2) There were 61 cases of non-stenosis group,60 cases of mild stenosis group,22 cases of moderate stenosis group,45 cases of severe stenosis group and 19 cases of occlusion group. There was a significant difference in the number of years of smoking among the groups. There was no statistical significance between the groups in age, number of smoking, smoking index, alcohol consumption and hcy. (2) Multiple stepwise linear regression analysis: the last number of years of smoking can enter the regression model at a = 0.05 level, and the degree of the posterior circulation of the vessel is positively related to the number of years of smoking (b = 0.256). The cerebral vascular stenosis was divided into two groups: the intracranial group, the extracranial group (1), the intracranial vascular stenosis group (1), the intracranial no-stenosis group (17 cases), the mild stenosis group (74 cases), the moderate stenosis group (26 cases), the severe stenosis group (34 cases) and the occlusion group (56 cases). There was a significant difference in the smoking index among the groups, and there was no statistical significance between the groups in the age, the number of years of smoking, the number of cigarettes, the alcohol consumption and the hcy. The final smoking index could not enter the regression model, and the relationship between the degree of stenosis of the intracranial vessel and the smoking index was not shown. (2) There were 14 cases of extracranial stenosis group (1), the extracranial non-stenosis group (n = 14), the mild stenosis group (121 cases), the moderate stenosis group (20 cases), the severe stenosis group (26 cases) and the occlusion group (26 cases). There was a significant difference in the number of years of smoking and the smoking index among the groups. There was no statistical significance between the groups in age, number of smoking, alcohol consumption and hcy. (2) the multiple stepwise linear regression analysis: the above two factors were analyzed by stepwise linear regression, and the last smoking index could enter the regression model. And the degree of extracranial vascular stenosis was positively related to the smoking index (b = 0.278). Conclusion 1. There was no correlation between the degree of cerebrovascular stenosis and the smoking index. There was no correlation between the degree of the posterior circulation of the vessel and the smoking index; the degree of the posterior circulation of the vessel was positively related to the number of years of smoking, the longer the number of years of smoking, the more the degree of stenosis of the posterior circulation vessel was, and the degree of the anterior circulation of the vessel was not related to the smoking index. There was a positive correlation between the degree of extracranial vascular stenosis and the smoking index, the greater the smoking index, the higher the degree of extracranial vascular stenosis, and the no correlation between the degree of intracranial vessel stenosis and the smoking index.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3
[Abstract]:Background Ischemic Cerebrovascular Disease (ICVD) has the characteristics of high incidence, high recurrence rate, and great harm[1], which is the main risk factor leading to disability. Recently, the relationship between smoking and ICVD is becoming more and more important, although the exact mechanism of smoking leading to ICVD and atherosclerosis is not completely clear, smoking has been identified as one of the independent risk factors for the onset of cerebral infarction. The smoking index is equal to the number of smokers per day and the number of years of smoking. Therefore, by studying the relationship between the smoking index and the degree and location of the cerebrovascular stenosis of the ICVD, the relationship between smoking and cerebrovascular stenosis can be quantified, and the theoretical basis for more effective prevention and control of ICVD is provided. Objective To study the relationship between smoking index and the degree of cerebral stenosis of ICVD, to quantify the relationship between smoking and cerebrovascular stenosis, and to provide a theoretical basis for more effective prevention and treatment of ICVD. Methods The patients with ICVD in the Central Hospital of Dalian were selected from January 2011 to December 2016, and the relevant data of the samples (cases) were collected, including age, sex, daily smoking count, number of years of smoking, hyperlipidemia, hypertension, diabetes, hyperhomocysteinemia (Hyperhomocysteinmia, etc.). "Hcy), alcohol consumption, degree of blood vessel stenosis and location, etc., were included in 207 male patients with hypertension and hyperlipidemia, respectively, and the degree of blood vessel stenosis and the location of each patient were recorded according to the report of the head and neck CTA, respectively, and the age between the different degree of stenosis of each group was compared and analyzed, respectively. There was no significant difference in the number of years of smoking, the number of cigarette smoking, the smoking index and other factors. The statistical software was used for statistical treatment with SPSS 21.0 for Windows. The difference was statistically significant, and the correlation between the factors and the degree of stenosis was further analyzed by the stepwise linear regression. Results 1. There were 76 cases of mild stenosis group,25 cases of moderate stenosis group,45 cases of severe stenosis group and 61 cases of occlusion group. There was no significant difference in age, number of years of smoking, number of smoking, smoking index, alcohol consumption and Hcy. According to the cerebral blood flow artery supply system, there were 7 cases with no stenosis group,111 cases of mild stenosis group,26 cases of moderate stenosis group,18 cases of severe stenosis group and 45 cases of occlusion group. There was no significant difference in age, number of years of smoking, number of smoking, smoking index, alcohol consumption and hcy among the groups. (2) There were 61 cases of non-stenosis group,60 cases of mild stenosis group,22 cases of moderate stenosis group,45 cases of severe stenosis group and 19 cases of occlusion group. There was a significant difference in the number of years of smoking among the groups. There was no statistical significance between the groups in age, number of smoking, smoking index, alcohol consumption and hcy. (2) Multiple stepwise linear regression analysis: the last number of years of smoking can enter the regression model at a = 0.05 level, and the degree of the posterior circulation of the vessel is positively related to the number of years of smoking (b = 0.256). The cerebral vascular stenosis was divided into two groups: the intracranial group, the extracranial group (1), the intracranial vascular stenosis group (1), the intracranial no-stenosis group (17 cases), the mild stenosis group (74 cases), the moderate stenosis group (26 cases), the severe stenosis group (34 cases) and the occlusion group (56 cases). There was a significant difference in the smoking index among the groups, and there was no statistical significance between the groups in the age, the number of years of smoking, the number of cigarettes, the alcohol consumption and the hcy. The final smoking index could not enter the regression model, and the relationship between the degree of stenosis of the intracranial vessel and the smoking index was not shown. (2) There were 14 cases of extracranial stenosis group (1), the extracranial non-stenosis group (n = 14), the mild stenosis group (121 cases), the moderate stenosis group (20 cases), the severe stenosis group (26 cases) and the occlusion group (26 cases). There was a significant difference in the number of years of smoking and the smoking index among the groups. There was no statistical significance between the groups in age, number of smoking, alcohol consumption and hcy. (2) the multiple stepwise linear regression analysis: the above two factors were analyzed by stepwise linear regression, and the last smoking index could enter the regression model. And the degree of extracranial vascular stenosis was positively related to the smoking index (b = 0.278). Conclusion 1. There was no correlation between the degree of cerebrovascular stenosis and the smoking index. There was no correlation between the degree of the posterior circulation of the vessel and the smoking index; the degree of the posterior circulation of the vessel was positively related to the number of years of smoking, the longer the number of years of smoking, the more the degree of stenosis of the posterior circulation vessel was, and the degree of the anterior circulation of the vessel was not related to the smoking index. There was a positive correlation between the degree of extracranial vascular stenosis and the smoking index, the greater the smoking index, the higher the degree of extracranial vascular stenosis, and the no correlation between the degree of intracranial vessel stenosis and the smoking index.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3
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