Peak Systolic Velocity Measurements with Transcranial Doppler Ultrasound Is a Predictor of Incident Stroke among the General Population in China.
Peak Systolic Velocity Measurements with Transcranial Doppler Ultrasound Is a Predictor of Incident Stroke among the General Population in China.
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DOI：
10.1371/journal.pone.0160967
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Wu YF
中科院分区：
文献类型：
--
作者：
Wang HB;Laskowitz DT;Dodds JA;Xie GQ;Zhang PH;Huang YN;Wang B;Wu YF
因此，有必要开发一种有效的、低成本的筛查工具，以识别中国卒中高危人群。经颅多普勒超声（TCD）是儿童镰状细胞病人群中卒中的有力预测因子，如STOP试验所示。我们的研究是在中国北京的一个前瞻性队列人群中进行的，目的是确定经颅多普勒（TCD）测量的收缩期峰值血流速度对随后卒中风险的预测价值。2002年，对北京市石景山区11个自然村的1392名居民进行了前瞻性队列研究。由流行病学家、护士和医生组成的研究小组计划在2005年、2007年和2012年对该队列的卒中事件进行随访。单变量和多变量考克斯比例风险回归模型被用来确定与卒中事件相关的因素。经TCD诊断为颅内动脉狭窄的患者发生卒中的风险是经TCD诊断为颅内动脉狭窄的患者的3.6倍（危险比（HR）3.57，95%可信区间（CI）1.86-6.83，P<0.01）。在调整其他危险因素或混杂因素后，多变量分析中的相关性仍然显著（HR 2.53，95%CI 1.31-4.87）。在控制了其他因素后，老年、吸烟、高血压和糖尿病仍然是统计学上显著的危险因素。本研究证实了TCD在中国城市普通人群中的筛查价值。增加TCD筛查的可用性可能有助于识别卒中风险较高的受试者。
It is necessary to develop an effective and low-cost screening tool for identifying Chinese people at high risk of stroke. Transcranial Doppler ultrasound (TCD) is a powerful predictor of stroke in the pediatric sickle cell disease population, as demonstrated in the STOP trial. Our study was conducted to determine the prediction value of peak systolic velocities as measured by TCD on subsequent stroke risk in a prospective cohort of the general population from Beijing, China. In 2002, a prospective cohort study was conducted among 1392 residents from 11 villages of the Shijingshan district of Beijing, China. The cohort was scheduled for follow up with regard to incident stroke in 2005, 2007, and 2012 by a study team comprised of epidemiologists, nurses, and physicians. Univariate and multivariate Cox proportional hazard regression models were used to determine the factors associated with incident stroke. Participants identified by TCD criteria as having intracranial stenosis had a 3.6-fold greater risk of incident stroke (hazard ratio (HR) 3.57, 95% confidence interval (CI) 1.86–6.83, P<0.01) than those without TCD evidence of intracranial stenosis. The association remained significant in multivariate analysis (HR 2.53, 95% CI 1.31–4.87) after adjusting for other risk factors or confounders. Older age, cigarette smoking, hypertension, and diabetes mellitus remained statistically significant as risk factors after controlling for other factors. The study confirmed the screening value of TCD among the general population in urban China. Increasing the availability of TCD screening may help identify subjects as higher risk for stroke.