| Objective:Stroke has been the 2~nd reason of death and the 1~st reason of disability worldwide.The carotid atherosclerosis could cause thickening of the internal carotid artery,formation of plaque,artery stenosis and embolism.And all of these could cause ischemic stroke,which could even lead to death.To provide intervention strategy for community stroke high risk population with cervical vascular abnormalities,the present study detect the risk factors of cervical vascular abnormalities in stroke high risk population whose age were above 40 in Qingdao.Hyperhomocysteinemia,which is associated with the onset,prognosis and recurrence of stroke,is the independent risk factor of stroke.As a result,it is necessary to study the related factors of serum homocysteinelevelinstrokehighriskpopulation,theriskfactorsof Hyperhomocysteinemia in stroke high risk population with cervical vascular abnormalities and observe the effect of folic acid and B vitamins supplication on serum homocysteine level in stroke high risk population.Methods:A total of 10007 permanent residents aged above 40 were chosen by cluster sampling as participants.By primary sorting,1478 cases were enrolled the study.The residents were assigned to case group and control group by cervical vascular abnormalities.All of the cases accepted questionnaire survey,physical examination and laboratory examination.The risk factors were analyzed by the method of case control study.The content of the questionnaire were about age,gender,medical history of stroke,TIA,diabetes and hypertension.And the height,weight,blood pressure,heart rate and waist circumference were measured.All the participants had carotid arteries auscultation,heart auscultation,ECG and carotid arteries B-type ultrasonic examination.Levels of Hcy,FPG,TC,TG,LDL-C and HDL-C in serum were tested.144 residents were chosen to participate in the intervention study.Participants as subjects were randomly assigned to intervention group(71 cases)and control group(73 cases),who were told to keep usual diet,and the subjects in the intervention group were daily given0.4mg folic acid,50?g vitamin B12 and 10mg vitamin B6 with usual diet.After 6-month intervention,levels of serum Hcy,TC,TG and LDL-Cin both groups were tested.Results:752 participants were diagnosedwith a cervical vascular abnormality.The rate of cervical vascular abnormalities in the stroke high risk population was 50.88%.The factors related to cervical vascular abnormalities were ranks as below:hypertension for83.91%,overweight or obesity for 75%,blood lipids abnormalities for 61.97%,lack of exercise for 41.22%,diabetes for 27.53%,smoking for 23.14%,heart disease for22.74%,alcoholism for 22.61%,TIAfor 16.49%and medical history of stroke for4.52%.By single factor analysis,the risk factors of cervical vascular abnormalities were hypertension,heart disease,smoking,alcoholism and large waist circumference.And physical exercise may be the protective factor.By logic multifactor regression analysis,OR values of hypertension,HHcy and LDL-C were 1.482(95%CI,1.136,1.266),1.336(95%CI,1.085,1.645)and 1.390(95%CI,1.155,1.671),respectively.In the intervention study,the folic acid and B vitamins intake level and serum Hcy level were same in both groups at the baseline.After intervention,the serum Hcy level significantly decreased in intervention group,however,levels of TC,TG,LDL-C and HDL-C had no change between two groups.Conclusion:The population with HHcy,hypertension,blood lipids abnormalities and exercise deficiency were more likely to have cervical vascular abnormalities.The supplication of folic acid and B vitamins could decreased the serum Hcy level in stroke high risk population,and possibly prevent cervical vascular abnormalities and stroke. |
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