青壮年脑卒中患者不良生活方式调查

doi:10.3969/j.issn.1006-9771.2022.01.004

摘要/Abstract

摘要：

目的调查脑卒中青壮年(18~59岁)的生活方式对发病的影响。方法 2020年10月至2021年3月,收集本院脑卒中住院患者268例(患者组)和同期本院门诊体检的健康人363例(对照组)的基本信息(性别、年龄、婚姻情况、文化水平),基于生活方式活动-兴趣-观点(AIO)量表和我国健康促进倡议设计生活方式问卷,调查吸烟、饮酒、睡眠、饮食、运动5个方面的信息,调查患者发病前的生活方式。进行单因素分析和多因素Logistic回归分析。结果吸烟频率高(OR = 1.383, P = 0.048)、被动吸烟频率高(OR = 1.511, P < 0.001)、睡眠时间短(OR = 0.582, P = 0.018)、熬夜(OR = 0.400, P < 0.001)、三餐时间不规律(OR = 0.454, P < 0.001)、每周早餐次数少(OR = 0.752, P = 0.012)、油脂摄入多(OR = 0.623, P < 0.001)、烧烤煎炸类食物摄入多(OR = 0.440, P < 0.001)、外卖或餐饮次数多(OR = 0.716, P < 0.001)、每次饮酒量大(OR = 1.502, P < 0.001)、有氧运动频率少(OR = 1.540, P < 0.001)为青壮年脑卒中发病的危险因素。结论不良生活方式影响青壮年脑卒中的发生。

关键词: 脑卒中, 青年, 中年, 生活方式, 危险因素

Abstract:

Objective To investigate the lifestyles for young and middle-aged stroke patients (aged 18 to 59). Methods From October, 2020 to March, 2021, 268 young adult stroke inpatients in Beijing Bo'ai Hospital and 363 healthy controls for healthy examination were collected the basic information (gender, age, marital status and educational level). The lifestyles were investigated with questionnaire based on Activity-Interest-Opinion (AIO) scale and Health Education and Health Advocacy in China, including 26 items in five dimensions of smoking, drinking, sleep, diet and exercise (before the onset for patients). The lifestyles were compared between the two groups, and analyzed with Logistic regression. Results Frequent smoking (OR = 1.383, P = 0.048), frequent passive smoking (OR = 1.511, P < 0.001), less sleeping time (OR = 0.582, P = 0.018), staying up later (OR = 0.400, P < 0.001), irregular meal time (OR = 0.454, P < 0.001), less weekly breakfast (OR = 0.752, P = 0.012), more oil intake (OR = 0.623, P < 0.001), more barbecue and fried food intake (OR = 0.440, P < 0.001), frequent takeaway or catering (OR = 0.716, P < 0.001), more alcohol consumption (OR = 1.502, P < 0.001) and less aerobic exercise (OR = 1.540, P < 0.001) were the risk factors for stroke in young and middle-aged persons. Conclusion Adverse lifestyle affects the occurrence of stroke in young and middle-aged people.

Key words: stroke, young, middle-aged, lifestyle, risk factors

中图分类号:

R743.3

孙宁,黄富表,叶婷. 青壮年脑卒中患者不良生活方式调查[J]. 《中国康复理论与实践》, 2022, 28(1): 24-31.

SUN Ning,HUANG Fubiao,YE Ting. Lifestyle for young and middle-aged stroke patients: 268 cases investigation[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(1): 24-31.

图/表 4

表1

表2

两组各变量单因素分析结果单位：n"

项目	变量	对照组 (n = 363)	患者组 (n = 268)	χ²值	P值	项目	变量	对照组(n = 363)	患者组(n = 268)	χ²值	P值
吸烟情况						饮食情况
吸烟频率	从不吸烟	284	140	74.534	< 0.001	盐的摄入	清淡	52	60	37.151	< 0.001
	已经戒烟	23	16				一般	227	102
	1~10支/d	26	16				较重	84	106
	> 10~20支/d	20	66			油脂摄入	高脂	71	100	26.499	< 0.001
	> 20支/d	10	30				低脂	41	32
吸烟年数	从不吸烟	283	140	53.959	< 0.001		适中	251	136
	≤ 5年	13	10			三餐时间是否规律	从不或很少规律	25	56	31.045	< 0.001
	> 5~15年	19	34				有时规律	45	42
	> 15~25年	31	38				经常或一直规律	293	170
	> 25年	17	46			早餐频率	每天	254	206	29.714	< 0.001
被动吸烟频率	从不或偶尔	183	60	116.092	< 0.001		5~6次/周	52	8
	1~2次/月	36	8				3~4次/周	26	22
	1~2次/周	50	22				1~2次/周	19	10
	3~5次/周	23	16				从不/很少	12	22
	每天	71	162			夜宵频率	每天	10	8	8.941	0.063
饮酒情况							5~6次/周	6	8
饮酒量/次^-1	从不或很少	221	114	35.178	< 0.001		3~4次/周	12	14
	< 100 g	64	46				1~2次/周	49	54
	100~200 g	47	44				从不/很少	286	184
	> 200 g	31	64
睡眠情况						每天摄入蔬菜300~500 g	很少	37	26	0.218	0.897
睡眠时间/h·d^-1	< 6	70	100	26.812	< 0.001		偶尔	116	82
	6~9	288	162				经常	210	160
	> 9	5	6			平均每天摄	< 200	243	178	1.515	0.469
						入水果/g	200~400	106	84
熬夜	否	260	126	39.315	< 0.001		> 400	14	6
	是	103	142			主食配杂粮情况	经常配有杂粮	89	78	16.792	< 0.001
午睡	否	217	154	0.342	0.559		偶尔配有杂粮	159	84
	是	146	114				很少配有杂粮	94	100
睡眠障碍	从不或很少	194	146	47.055	< 0.001		只食用杂粮	2	0
	有时	116	34				很少食用主食及杂粮	19	6
	经常或一直	53	88			饮食以什么为主	偏蔬菜瓜果	84	36	27.502	< 0.001
运动情况							偏肉类	83	108
有氧运动频率/周^-1 (快走/跑步/骑行/游泳等)	从不/很少	169	110	39.764	< 0.001		偏豆制品/奶制品类	25	24
	1~2	104	46				营养均衡	146	84
	3~5	56	38				其他	25	16
	6~7	34	74			烧烤煎炸类食物摄入	从不	26	76	61.494	< 0.001
无氧运动频率	从不/很少	254	210	7.827	0.050		有时	302	152
(哑铃/弹力带/核心力量	1~2次/月	47	18				经常	35	40
/俯卧撑等)	1~2次/周	29	20			外卖/餐饮频率	每天	20	24	27.106	< 0.001
	3次以上/周	33	20				5~6次/周	29	42
运动频率/ h·d^-1	0~1	256	180	4.899	0.179		3~4次/周	41	50
	> 1~2	81	72				1~2次/周	153	72
	> 2~3	9	10				从不/很少	120	80
	> 3	17	6

表2

表3

表4

参考文献 46

[1]	顾慧妹, 顾亚英, 陆金雯, 等. 青年脑卒中危险因素的研究进展[J]. 全科护理, 2019, 17(32):4007-4010.
	GU H M, GU Y Y, LU J W, et al. Research progress of risk factors for stroke in young people[J]. Gener Nurs, 2019, 17(32):4007-4010.
[2]	罗慧, 温贤秀, 何邦, 等. 成都市社区脑卒中筛查及其危险因素分析[J]. 西部医学, 2018, 30(5):756-758, 768.
	LUO H, WEN X X, HE B, et al. Stroke screening and risk factors analysis in Chengdu City[J]. Western Med J, 2018, 30(5):756-758, 768.
[3]	林琳, 黄益洪, 李秋萍, 等. 天津地区≥35岁高血压人群脑卒中发病现况及危险因素[J]. 中国老年学杂志, 2017, 37(15):3867-3869.
	LIN L, HUANG Y H, LI Q P, et al. Prevalence and risk factors of stroke in 35-year-old hypertension patients in Tianjin[J]. Chin J Gerontol, 2017, 37(15):3867-3869.
[4]	徐小鹤. 青年脑卒中不可控的危险因素分析[J]. 实用妇科内分泌电子杂志, 2017, 4(28):94-95.
	XU X H. Analysis of risk factors for stroke in young adults[J]. J Clin Endocrinol, 2017, 4(28):94-95.
[5]	赵宗权, 吴贻红, 汤振源, 等. 苏州市50岁以上人群脑卒中危险因素调查分析[J]. 川北医学院学报, 2017, 32(4):613-615.
	ZHAO Z Q, WU Y H, TANG Z Y, et al. Analysis of risk factors for stroke in patients over 50 years of age in Jiangsu province[J]. J North Sichuan Med College, 2017, 32(4):613-615.
[6]	张春丽, 高红红, 孟胜君. 青年隐源性卒中危险因素分析[J]. 中国实用神经疾病杂志, 2017, 20(8):121-123.
	ZHANG C L, GAO H H, MENG S J. Risk factors of latent stroke in young adults[J]. Chin J Neurol, 2017, 20(8):121-123.
[7]	朱向梅, 彭亚萍. 基于AIO量表的山西省老年人生活方式[J]. 中国老年学杂志, 2019, 39(12):3063-3065.
	ZHU X M, PENG Y P. Lifestyle of the elderly in Shanxi Province based on AIO scale[J]. Chin J Gerontol, 2019, 39(12):3063-3065.
[8]	沈蕾, 成志明. 新生代农民工内部结构分化研究:基于AIO生活方式量表的调研[J]. 预测, 2014, 33(2):44-49.
	SHEN L, CHENG Z M. Research on internal structure differentiation of the new generation of migrant workers based on AIO Lifestyle Scale[J]. Prediction, 2014, 33(2):44-49.
[9]	CHICHIREZ C M, PURCĂREA V L. Health marketing and behavioral change: a review of the literature[J]. J Med Life, 2018, 11(1):15-19.
[10]	石文惠, 王静雷, 杨一兵, 等. 全民健康生活方式行动助力健康中国建设[J]. 中国慢性病预防与控制, 2019, 27(10):721-723.
	SHI W H, WANG J L, YANG Y B, et al. Chin J Chron Dis Prev Control, 2019, 27(10):721-723.
[11]	曹文君, 郭颖, 平卫伟, 等. HPLP-Ⅱ健康促进生活方式量表中文版的研制及其性能测试[J]. 中华疾病控制杂志, 2016, 20(3):286-289.
	CAO W J, GUO Y, PING W W, et al. Development and performance test of Chinese version of HPLP-Health Promotion Lifestyle Scale[J]. Chin J Dis Control, 2016, 20(3):286-289.
[12]	张索磊, 王熙. 北京市朝阳区全民健康生活方式行动效果评估[J]. 中国健康教育, 2017, 33(2):132-135.
	ZHANG S L, WANG X. Effect evaluation of National Healthy Lifestyle Action in Chaoyang District in Beijing[J]. Chin J Health Educ, 2017, 33(2):132-135.
[13]	唐钧. 生活方式与整体健康观[J]. 哈尔滨工业大学学报(社会科学版), 2020, 22(1):38-44.
	TANG J. Lifestyle and holistic health outlook[J]. J Harbin Inst Technol (Soc Sci Ed), 2020, 22(1):38-44.
[14]	刘友良. 树立健康新理念建立健康生活方式[J]. 中国机关后勤, 2012(6):40-41.
	LIU Y L. Establish a new concept of health and establish a healthy lifestyle[J]. Chin Govern Logist, 2012(6):40-41.
[15]	葛锡泳, 胡一可. 苏州市居民脑卒中流行现状及危险因素分析[J]. 中国初级卫生保健, 2011, 25(11):77-79.
	GE X Y, HU Y K. Prevalence and risk factors of stroke in Suzhou city[J]. Chin J Primary Health Care, 2011, 25(11):77-79.
[16]	张亚静, 吴寿岭, 李慧英, 等. 血压对不同年龄人群动脉僵硬度的影响[J]. 中华心血管病杂志, 2018, 46(1):56-63.
	ZHANG Y J, WU S L, LI H Y, et al. Influence of blood pressure on arterial stiffness in different age groups[J]. Chin J Cardiol, 2018, 46(1):56-63.
[17]	«中国脑卒中防治报告2018»编写组. 我国脑卒中防治仍面临巨大挑战:«中国脑卒中防治报告2018»概要[J]. 中国循环杂志, 2019, 34(2):105-119.
	Chinese Stroke Prevention and Treatment Report 2018 Compilation Group. Chinese Stroke Prevention and Treatment Report 2018 Summary Report 2018 Compilation Group. Chinese Stroke Prevention and Treatment Report 2018 Summary[J]. Chin J Circ, 2019, 34(2):105-119.
[18]	胡芳芳, 解源源, 王婷, 等. 生活方式干预结合中医辨体施养在社区脑卒中高危人群中的应用[J]. 齐鲁护理杂志, 2021, 27(5):140-142.
	HU F F, XIE Y Y, WANG T, et al. Application of lifestyle intervention combined with Traditional Chinese Medicine in high-risk population of cerebral apoplexy in community[J]. Qilu J Nurs, 2021, 27(5):140-142.
[19]	BAILEY R R, PHAD A, MCGRATH R, et al. Prevalence of five lifestyle risk factors among U.S. adults with and without stroke[J]. Disabil Health J, 2019, 12(2):323-327. doi: 10.1016/j.dhjo.2018.11.003
[20]	HILL V A, VICKREY B G, CHENG E M, et al. A pilot trial of a lifestyle intervention for stroke survivors: design of Healthy Eating and Lifestyle after Stroke (HEALS)[J]. Stroke Cerebrovasc Dis, 2017, 26(12):2806-2813.
[21]	SUN P, LIU L, LIU C, et al. Carotid intima-media thickness and the risk of first stroke in patients with hypertension[J]. Stroke, 2020, 51(2):379-386. doi: 10.1161/STROKEAHA.119.026587
[22]	王旭. 吸烟对健康的危害及控烟策略分析[J]. 特别健康, 2018(13):22-23.
	WANG X. Analysis of health hazards of smoking and tobacco control strategies[J]. Special Health, 2018(13):22-23.
[23]	李建标, 何锦照, 江震钦. 不良生活方式、负性情绪与脑卒中的相关性研究[J]. 临床医学工程, 2017, 24(11):1531-1533.
	LI J B, HE J Z, JIANG Z Q. Study on the relationship between adverse lifestyle, negative emotion and stroke[J]. Clin Med Eng, 2017, 24(11):1531-1533.
[24]	熊芳, 李纯芬, 周焱琳, 等. 健康体检人群体质指数与血糖、血脂及血压的相关性分析[J]. 中国医学前沿杂志(电子版), 2015(4):68-71.
	XIONG F, LI C F, ZHOU Y L, et al. Correlation analysis of body mass index with blood glucose, lipid and blood pressure in healthy people[J]. Chin J Med Front (Elec Ed), 2015(4):68-71.
[25]	孙宝利. 吸烟对脑卒中患者血浆组织因子水平的影响[J]. 中国实用神经疾病杂志, 2015(1):98-99.
	SUN B L. Chin J Pract Neuropath, 2015(1):98-99.
[26]	齐士格, 王志会, 李志新, 等. 2013年中国老年人睡眠时间分布及其与脑卒中的关系[J]. 中国医学前沿杂志(电子版), 2016, 8(6):109-114.
	QI S G, WANG Z H, LI Z X, et al. Sleep duration distribution and its relationship with stroke in elderly Chinese in 2013[J]. Chin J Med Front (Elec Ed), 2016, 8(6):109-114.
[27]	霍富元. 海珠区居民脑血管病危险因素分层管理及社区综合干预研究:不同类型体力活动与缺血性脑卒中相关性研究[D]. 广州:南方医科大学, 2013.
	HUO F Y. Study on the relationship between different types of physical activity and ischemic stroke in Haizhu District[D]. Guangzhou: Southern Medical University, 2013.
[28]	朱维春, 黄叔恺, 邓春花. 睡眠时间与缺血性脑卒中发生风险的相关性研究[J]. 世界睡眠医学杂志, 2021, 8(7):1140-1141.
	ZHU W C, HUANG S K, DENG C H. The relationship between sleep duration and risk of ischemic stroke[J]. World J Sleep Med, 2021, 8(7):1140-1141.
[29]	武海滨, 王浩, 胡如英, 等. 成年人睡眠时间与脑卒中患病关系的研究[J]. 中华流行病学杂志, 2015, 36(11):1210-1215.
	WU H B, WANG H, HU R Y, et al. Study on the relationship between sleep duration and stroke in adults[J]. Chin J Epidemiol, 2015, 36(11):1210-1215.
[30]	LARSSON S C, WALLIN A, WOLK A, et al. Differing association of alcohol consumption with different stroke types: a systematic review and meta-analysis[J]. BMC Med, 2016, 14(1):178. doi: 10.1186/s12916-016-0721-4
[31]	肖筱婵, 陈赛男, 谭迎, 等. 血清标志物对动脉粥样硬化脑梗死的临床价值[J]. 广东医学, 2020, 41(15):1616-1621.
	XIAO X C, CHEN S N, TAN Y, et al. Clinical value of serum markers in patients with atherosclerotic cerebral infarction[J]. Guangdong Med, 2020, 41(15):1616-1621.
[32]	唐玫, 唐丽坤, 李颖, 等. 桂林地区社区脑卒中人群饮食习惯和生活方式的分析[J]. 中外医学研究, 2020, 18(2):173-175.
	TANG M, TANG L K, LI Y, et al. Dietary habits and lifestyle analysis of stroke population in Guilin area[J]. Chin J Med Res, 2020, 18(2):173-175.
[33]	LIBERALE L, BONAVENTURA A, MONTECUCCO F, et al. Impact of red wine consumption on cardiovascular health[J]. Curr Med Chem, 2019, 26(19):3542-3566. doi: 10.2174/0929867324666170518100606
[34]	REES K, TAKEDA A, MARTIN N, et al. Mediterranean-style diet for the primary and secondary prevention of cardiovascular disease[J]. Cochrane Database Syst Rev, 2019, 3(3):009825.
[35]	CHIVA-BLANCH G, BADIMON L. Benefits and risks of moderate alcohol consumption on cardiovascular disease: current findings and controversies[J]. Nutrients, 2019, 12(1):108. doi: 10.3390/nu12010108
[36]	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国脑血管病一级预防指南2015[J]. 中华神经科杂志, 2015, 48(8):629-643.
	Chinese Society of Neurology, Chinese Society of Neurology, Cerebrovascular Group. Guidelines for Primary Prevention of Cerebrovascular Disease in China 2015[J]. Chin J Neurol, 2015, 48(8):629-643.
[37]	KRENZ M, KORTHUIS R J. Moderate ethanol ingestion and cardiovascular protection: from epidemiologic association to cellular mechanisms[J]. J Mol Cell Cardiol, 2012, 52(1):93-104. doi: 10.1016/j.yjmcc.2011.10.011
[38]	SHAH M, PAULSON D. C-reactive protein level partially mediates the relationship between moderate alcohol use and frailty: the Health and Retirement Study[J]. Age Ageing, 2016, 45(6):874-878. doi: 10.1093/ageing/afw103
[39]	ALISSA E M, FERNS G A. Dietary fruits and vegetables and cardiovascular diseases risk[J]. Crit Rev Food Sci Nutr, 2017, 57(9):1950-1962.
[40]	GUO J, GUAN T, SHEN Y, et al. Lifestyle factors and gender-specific risk of stroke in adults with diabetes mellitus: a case-control study[J]. Stroke Cerebrovasc Dis, 2018, 27(7):1852-1860.
[41]	ŻEGLEŃ M, KRYST Ł, KOWAL M, et al. Changes in the prevalence of overweight/obesity and adiposity among pre-school children in Kraków, Poland, from 2008 to 2018[J]. Biosoc Sci, 2020, 52(6):895-906.
[42]	李佳霖, 刘金玲, 吴凡, 等. 急性缺血性脑卒中患者血棕榈酸、ω6、ω3与LDL-C相关性研究[J]. 中国实验诊断学, 2021, 25(7):1011-1013.
	LI J L, LIU J L, WU F, et al. Relationship between blood palmitic acid ω6 ω3 and LDL-C in patients with acute ischemic stroke[J]. Chin J Exp Diag, 2021, 25(7):1011-1013.
[43]	杜秋明, 曹书华, 苏玫, 等. 不同年龄和性别脑卒中患者危险因素及预后[J]. 中国老年学杂志, 2021, 41(7):1374-1377.
	DU Q M, CAO S H, SU M, et al. Risk factors and prognosis of stroke patients with different age and gender[J]. Chin J Gerontol, 2021, 41(7):1374-1377.
[44]	BVENURA C, SIVAKUMAR D. The role of wild fruits and vegetables in delivering a balanced and healthy diet[J]. Food Res Int, 2017, 99(1):15-30. doi: 10.1016/j.foodres.2017.06.046
[45]	李颖, 唐玫, 唐丽坤, 等. 桂林地区某医院脑卒中高危人群生活方式和饮食习惯现状调查以及危险因素分析[J]. 实用预防医学, 2018, 25(10):1190-1194.
	LI Y, TANG M, TANG L K, et al. Analysis of lifestyle and dietary habits and risk factors among patients at high risk of stroke in a hospital in Guangxi[J]. Pract Prev Med, 2018, 25(10):1190-1194.
[46]	林蓓蕾, 张振香, 王文娜, 等. 脑卒中患者有氧运动推荐意见解读[J]. 护理学杂志, 2021, 36(11):28-32.
	LIN B L, ZHANG Z X, WANG W N, et al. Recommendations on aerobic exercise in patients with cerebral apoplexy[J]. J Nurs, 2021, 36(11):28-32.

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来源	本网站	其他网站

次数	223	247
比例	47%	53%

自变量	B	SE	Wald	P值	OR	95%CI
吸烟频率	0.324	0.171	3.600	0.048	1.383	0.989~1.934
吸烟年数	0.087	0.151	0.330	0.566	0.917	0.682~1.233
被动吸烟频率	0.413	0.074	31.128	< 0.001	1.511	1.307~1.746
饮酒量	0.407	0.081	25.201	< 0.001	1.502	1.282~1.761
睡眠时间	-0.542	0.229	5.588	0.018	0.582	0.371~0.912
熬夜	0.916	0.220	17.367	< 0.001	0.400	0.260~0.616
睡眠障碍	0.111	0.105	1.120	0.290	1.117	0.910~1.373
有氧运动频率	0.432	0.100	18.552	< 0.001	1.540	1.265~1.874
盐的摄入	0.211	0.155	1.859	0.173	1.235	0.912~1.672
油脂摄入	0.473	0.114	17.097	< 0.001	0.623	0.498~0.780
三餐时间是否规律	-0.789	0.138	32.778	< 0.001	0.454	0.347~0.595
早餐频率	-0.286	0.114	6.262	0.012	0.752	0.601~0.940
主食配有杂粮情况	-0.083	0.115	0.521	0.470	0.920	0.734~1.153
饮食中以什么为主	-0.059	0.808	0.544	0.461	0.943	0.806~1.103
烧烤煎炸类食物摄入	0.822	0.222	13.652	< 0.001	0.440	0.284~0.680
外卖/餐饮频率	-0.334	0.090	13.845	< 0.001	0.716	0.601~0.854