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目的 探讨体检人群脑血管功能积分值的分布特征以及与脑卒中危险因素暴露水平的关系.方法 2013年6月-2014年6月,在中南大学湘雅三医院健康管理中心完成脑血流动力学检测的1 840名年龄23～88岁的体检人群为研究对象,计算脑血管功能积分值,以75分为截点,分为＜75组(396例)和≥75分组(1 444例),描述脑血管功能积分值的人群分布特征,分析脑血管功能积分值异常变化与传统危险因素以及同期血糖、血脂及超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、臂踝脉搏波传导速度(baPWV)和颈动脉内膜中层厚度(CIMT)等指标的关系.结果 本组人群脑血管功能积分值(＜75分)异常率随着年龄递增而上升.＜75分组的年龄、高血压病史、糖尿病病史、脑卒中家族史、体质指数(BMI)、腰围、收缩压、舒张压、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、三酰甘油(triglyceride,TG)、空腹血糖(fasting plasma glucose,FPG)、hs-CRP、Hcy、baPWV和CIMT均显著高于≥75分组,差异有统计学意义(P均＜0.05).相关性分析显示,年龄、高血压病史、糖尿病史、BMI、腰围、收缩压、舒张压、LDL-C、TG、FPG、hs-CRP、Hcy、baPWV等与脑血管功能积分值呈显著负相关,与HDL-C呈显著正相关(P＜0.05).多因素Logistic回归分析显示,年龄[OR(95％CI):1.017 (1.002～1.033)]、高血压病史[OR (95％CI):1.510(1.096～ 2.081)]、BMI[OR (95％CI):1.235 (1.135～1.344)]、收缩压[OR(95％CI):1.044(1.030～1.059)]、LDL-C[OR(95％CI):1.673(1.444～1.937)]、TG[OR(95％CI):¨16(1.035 ～ 1.204)]、hs-CRP[OR(95％CI):1.037(1.003～1.073)]、Hcy[OR(95％CI):1.099(1.062～ 1.136)]、baPWV[OR(95％CI):1.001(1.000 ～ 1.002)]是脑血管功能积分值降低的独立影响因素.结论 脑血管功能积分值异常与脑卒中危险因素暴露水平密切相关.脑血管功能积分值的测定是中老年体检人群脑卒中高危人群筛查简便、可行的手段.

Objective To investigate the changes of cerebrovascular hemodynamic accumulative score in health checkup population and their influencing factors.Methods A total of 1 840 people aged 23-88 years were checked by CVHI and accumulative scores were calculated.The general information,blood biochemistry,highly sensitive C-reaction protein (hs-CRP),homocysteine (Hcy),carotid intima-media thickness (CIMT) and brachial-ankle pulse wave velocity (baPWV) were also collected during the corresponding period.Results The proportion of abnormal CVHI accumulative score (＜75 points) was increasing with age.Compared with the normal CVHI accumulative score (≥75 points) group,the proportion of hypertensive disease,diabetes and stroke family history was significantly higher in the abnormal group (P＜ 0.05).In addition,the levels of age,body mass index (BMI),waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),fasting plasma glucose (FPG),hs-CRP,Hcy,CIMT and baPWV were also significantly increased in the abnormal group (P＜0.05).Correlation analysis showed a negative correlation between CVHI accumulative score and age,history of hypertension,diabetes,BMI,WC,SBP,DBP,LDL-C,TG,FPG,hs-CRP,Hcy,baPWV (P＜ 0.05),but a positive correlation with HDL-C (P＜0.05).Multiple factor analysis determined that age [OR(95％C1):1.017(1.002-1.033)],history of hypertension [OR(95％CI):1.510(1.096-2.081)],BMI [OR(95％CI):1.235(1.135-1.344)],SBP [OR(95％CI):1.044(1.030-1.059)],LDL-C [OR(95％CI):1.673(1.444-1.937)],TG [OR(95％CI):1.116(1.035-1.204)],hs-CRP [OR(95％CI):1.037(1.003-1.073)],Hcy [OR(95％CI):1.099(1.062-1.136)],baPWV [OR(95％CI):1.001(1.000-1.002)] were being selected into the regression model (P＜0.05),and they were independent influencing factors of decreased CVHI accumulative scores.Conelusion The decreased CVHI accumulative score has a significant relationship with exposure levels of risk factors in stroke.Therefore,we conclude that the detection of CVHI is a convenient and feasible method to screen high risk individuals for stroke in middle and old aged population undergoing medical examination.