【摘要】：目的建立高血壓患者并發(fā)腦卒中的風險評估模型。方法通過Meta分析的方法獲得高血壓患者并發(fā)腦卒中的危險因素及相應的合并風險值,構建Rothman-Keller模型的危險評分表,再通過二項分布函數(shù)方法生成一組隨機數(shù)據(jù)集,確定風險評估等級劃分界值,并采用實際數(shù)據(jù)驗證。結果共納入31篇文獻,進入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、頸動脈斑塊、是否規(guī)律服藥、體育鍛煉、吸煙。實際人群發(fā)病情況與模型預測結果的ROC曲線下面積及95%CI為0.784(0.718,0.849),P0.001。結論本模型的預測效果較好,可以應用于高血壓患者并發(fā)腦卒中的一級預防,有助于降低高血壓患者并發(fā)腦卒中的風險。
[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)大學軍事預防醫(yī)學院衛(wèi)生統(tǒng)計學教研室;第三軍醫(yī)大學大坪醫(yī)院野戰(zhàn)外科研究所第九研究室;
【基金】：國家自然科學基金面上項目(81473068,81202286)~~
【分類號】：O213;R544.1;R743.3
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本文編號：2435035