| Objective: The independent effects of risk factors on stroke with h-type hypertension,the important interactions and gender differences were investigated by subgroup analysis;In order to provide a reliable reference basis for risk stratification and provide a basis for clinical diagnosis and treatment.Methods: In October 2016 to June 2019,the first hospital of lanzhou university neurology department Hospitalized patients with acute cerebral infarction(408 cases),and the non-acute cerebral infarction patients in the same periods(n=377cases).Review of medical records,collecting hospital admission and discharge end with relevant information.At the same time,collect the patient's baseline data and laboratory testing indicators;stratify all the data,analyze the interaction between various factors and gender differences.Finally,SPSS 25.0 statistical software was used for analysis.The results were expressed as coefficient(?),standard error(SE),odds ratio(OR),95% confidence interval(95%CI).All trials were 2-sided,P < 0.05 was considered signifificant.Result:(1)The levels of UA,Hcy,Lp-PLA2 in the H-type hypertension group were higher than other group;smoking,drinking,and hyperuricemia were higher than those in the pure hypertension group;SBP,DBP,stroke rates were higher than the pure HHcy group;the differences were statistically significant(P <0.05).2 DBP,GLU,Hcy,UA,smoking,drinking and stroke were higher in men than in women,while the levels of age,TC,HDL-C,and LDL-C were lower than women,the differences were statistically significant(P <0.05).3 SBP,smoking,drinking,hyperuricemia,RDW,Hcy,Lp-PLA2 increased and HDL-C level decreased are risk factors for stroke;DBP increase in women is also a risk factor for stroke.4 There was an interaction between gender and age,DBP,TG,UA,RDW,and Hcy,the differences were statistically significant(P<0.05).5 Hcy level and SBP,DBP,TC,TG,HDL-C,RDW,hyperuricemia and drinking,the differences are statistically significant(P<0.05);The interaction of Hcy and age,DBP,RDW affects women's stroke risk,and the interaction of TG affects men 's stroke risk.6 There is an interaction between RDW and dyslipidemia,SBP,TG.There is no gender difference was found.7 There was no interaction between Lp-PLA2 and other risk factors.8 The level of Hcy,RDW,Lp-PLA2 were significantly correlated with hypertension risk and BP levels,positive correlation with severity of H-type hypertension with acute cerebral infarction on admission.9 Hcy,RDW,UA,Lp-PLA2 have certain diagnostic efficacy for H-type hypertension with acute cerebral infarction.The area under the curve(AUC)respectively 0.789,0.763,0.576,0.614,but none are as good as the combined detection(AUC=0.853);The diagnostic sensitivity and specificity of Lp-PLA2 are higher than other indicators.Conclusion:(1)There are a gender difference in the risk of H-type hypertension stroke,and the stroke rate of men is higher than women;there is an interaction between gender,Hcy,RDW and other factors.On the one hand,it independently on H-type hypertensive with stroke;on the other hand,it has a multiplier effect with other factors.(2)Hcy,RDW,Lp-PLA2 are significantly associated with the susceptibility of hypertension and the level of blood pressure,are risk factors for H-type hypertension stroke,and are positively correlated with the severity of admission.Them for joint detection,which is beneficial to diagnosis of H-type hypertension with stroke,provide the basis for subsequent treatment. |
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