[Distribution of cerebral vascular hemodynamic indexes].

OBJECTIVE: To describe the distribution of cerebral vascular hemodynamic indexes (CVHI). METHODS: A number of 25,355 age 35 and over were selected in the Northeast China by cluster sampling. CVHI were checked during baseline survey and were followed to see the occurrence of stroke. Distribution of CVHI among non-stroke population, individuals prior to the onset of stroke and patients with stroke were described. RESULTS: The CVHI accumulative score, V(mean), V(max) and V(min) were dramatically decreasing, but RV, Zcv, WV and DR were significantly increasing as age increased. V(max), RV and CP were significantly higher in males but WV was lower than that of females. The CVHI accumulative score, V(min) and RV were 95.0, 10.23 and 75.8 in non-stroke population, 51.25, 6.71 and 122.72 pre stroke group, and 55.0, 6.78 and 115.89 in patients with stroke respectively. There were significant differences among three groups after controlling of age and sex (P < 0.01). CONCLUSION: Variance of CVHI was closely related to age, and there appeared a significant abnormal of CVHI before and after stroke.

[A cohort study on cerebral vascular hemodynamics accumulative score and risks of stroke].

OBJECTIVE: To estimate relative risk (RR) of cerebral vascular hemodynamics indexes (CVHI) accumulative score as well as some other risk factors of stroke. METHODS: A cohort study was carried out in 25 355 participants aged 35 and over in Northeast of China from 1994 to 2001. In the baseline survey, exposure rates of hypertension, diabetes, family history of stroke and hypertension, etc. were collected and CVHI was examined. CVHI accumulative score was synthesized according to contribution of single index. During the 7-year following up, 228 stroke cases were identified and stroke coming on was defined as the endpoint of observation. Uni-variable and multiple variables analysis were carried out for estimating RR of CVHI and other risk factors of stroke. RESULTS: Uni-variables analysis indicated that RR (95% confidence interval, CI) of Hypertension, heart diseases, diabetes, family history of hypertension and stroke, overweight or obesity, alcohol intake, cigarette smoking and CVHI < 75 scores were 3.23 (2.48 - 4.20), 2.53 (1.92 - 3.33), 2.38 (1.55 - 3.64), 1.32 (1.02 - 1.72), 1.82 (1.37 - 2.41), 1.62 (1.25 - 2.11), 1.48 (1.07 - 2.04), 1.76 (1.34 - 2.31) and 7.30 (5.43 - 9.80) respectively. Cox regression analysis showed that CVHI below 75 points, family history of stroke, cigarette smoking, heart disease, hypertension, age and sex were the factors being selected in equation. There was a significant dosage response between the decrease of CVHI score and the increase of stroke risk. RR of stroke reached 12.55 when CVHI below 75 points and history of hypertension appeared in the same individuals. CONCLUSION: Abnormality of CVHI score seemed to be the most important and independent factor among stroke risk factors. Decrease of CVHI score might serve as a marker of high risk and play important role in stroke, especially coexistence with hypertension.

[Study on a test of screening to predict stroke-using cerebral vascular hemodynamic indexes].

OBJECTIVE: To evaluate efficacy and optimal cut-off-point through cerebral vascular hemodynamic indexes (CVHI) examination to predict stroke. METHODS: A number of 20,333 people at 35 years old and over were checked by CVHI and accumulative score was calculated according to the value of detected indexes. Risk factors of stroke were investigated simultaneously. One hundred and sixty-eight patients with stroke occurred during 4-year following up. Typical syndromes and signs stroke were used as golden standard to evaluate screening efficacy of CVHI. RESULTS: Score of optimal cut-off-point of cerebral vascular hemodynamic indexes was under 75 in ROC curve analyses. Sensitivity, specificity, accuracy, positive and negative predictive values, positive and negative likelihood ratios as well as Youden's index for predicting stroke within 4 years after examination were found to be 87.50%, 67.70%, 67.86%, 2.21%, 99.85%, 2.71, 0.18 and 0.55 respectively. Sensitivity and positive predict values for predicting cerebral vascular thrombosis were superior to predicting cerebral hemorrhage. Positive predicting value in risk exposure population was higher than that of overall population. Coefficiency of variation of cerebral vascular hemodynamic examination was 4.03%. The agreement rate of examination between two physicians was 97.62% and Kappa value was 0.94. CONCLUSION: The score of optimal cut-off-point of cerebral vascular hemodynamic indexes examination was 75. Both Efficacy and reliability for predicting stroke seemed to be good, especially for predicting cerebral vascular thrombosis.