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研究生:黃麗卿
研究生(外文):Hwang,Lee-Ching
論文名稱:致死性腦中風及冠狀動脈心臟病多重危險因子之重疊病例對照研究
論文名稱(外文):A Nested Case-Control Study on Multiple Risk Factors of Acute Fatal Cerebrovascular Accident and Coronary Heart Disease
指導教授:陳建仁陳建仁引用關係
指導教授(外文):Chen,Chien-Jen
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:公共衛生學研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:1993
畢業學年度:81
語文別:中文
論文頁數:76
中文關鍵詞:流行病學腦中風冠狀動脈心臟病危險因子
外文關鍵詞:epidemiologystrokecoronary heart diseaserisk factor
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台灣是腦中風高盛行及冠狀動脈心臟病低盛行地區, 其冠狀動脈心臟病
死亡率,並未像歐美國家呈現下降趨勢,反而持續升高。 若將腦中風與
冠狀動脈心臟病合計, 即高居台灣地區十大死因之首位,這兩種疾病的
預防是公共衛生的重要課題。 本研究以台灣地區六個鄉鎮之 7763 名成
人居民為長期追蹤世代,在十年追蹤期間,共發現 39名急性致死性冠狀
動脈心臟病患者,以及 108 名急性致死性腦中風患者,按照病例之年齡
、性別、採血與否及居住鄉鎮,利用一比四匹配方式選出 588 名健康對
照,進行重疊病例對照研究, 以期探討在台灣地區腦中風及冠狀動脈心
臟病之危險因子。研究結果顯示: 高血膽固醇與高血壓是急性致死性腦中
風 ( 主要為腦出血 ) 的重要危險因子,其多變項調整後相對危險比分別
為 7.5, 6.4 ;而血三酸甘油脂偏高則有保護作用。 高血壓、心臟病家
族史、低運動量為急性致死性冠狀動脈心臟病之重要危險因子, 其多變
項調整後相對危險比分別為 7.6, 7.2, 3.6; 運動習慣則具有保護作用;
而抽煙、飲酒、肥胖則與腦中風及冠狀動脈心臟病無統計顯著相關。 故
動脈粥狀硬化疾病之預防,應加強高血壓與高膽固醇的控制,並鼓勵適當
的運動。

Stroke is more prevalent and coronary heart disease (CHD) is
less prevalent in Taiwan in comparison with industrial
countries. In North America and Europe CHD is becoming less
epidemic, while its morbidity and mortality increasing in
Taiwan. Stroke combined with coronary heart disease is the
leading casuse of death in Taiwan. The prevention of stroke
and CHD is an important public health task. In order to
compare risk factors of stroke and CHD, a total 7763 adults
have been selected from 6 townships in Taiwan and followed-up
for more than 10 years. There were 39 deaths from acute
coronary heart disease and 108 deaths from acute stroke.
Another 588 health controls were matched with dead stroke and
CHD cases on age, sex, blood collection status, and
residential township. The results indicated that
hypertension, hyperchole- strolemia were the primary risk
factors associated with acute fatal stroke, mainly
cerebral hemorrhage. Their multivariate- adjusted odds
ratios were 7.5 and 6.4; while elevated serum triglyceride
level negatively associated with the disease. Hyper- tension,
heart disease family history,and low physical activity were
major risk factors of acute fatal coronary heart disease.
Their multivariate-adjusted odds ratio were 7.6, 7.3, and
3.6 respectively. Furthermore,cigarette smoking,alcohol
drinking, and obesity were not significantly associated with
acute fatal stroke and CHD. In order to prevent these two
atherosclerotic disease, reinforced program to hypertension
and hypercholesterlemia as well as to promote proper exercise
is highly recommended.

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