血漿凝血因子Ⅹ和Ⅺ水平與新發(fā)中風、急性冠脈綜合征風險的關聯(lián)性及影響因素分析摘要：

目的：研究血漿凝血因子Ⅹ和Ⅺ水平與新發(fā)中風、急性冠脈綜合征(AcuteCoronarySyndrome,ACS)風險的關聯(lián)性及影響因素。

方法：共納入新發(fā)中風和ACS患者278例，對其血漿凝血因子Ⅹ和Ⅺ水平進行檢測，并采用多元邏輯回歸分析，探討兩者與新發(fā)中風、ACS風險的關系及其影響因素。

結果：①血漿凝血因子Ⅹ和Ⅺ水平在新發(fā)中風組和ACS組均高于對照組(P<0.05)；②多元邏輯回歸分析結果表明，血漿凝血因子Ⅺ水平是新發(fā)中風的獨立危險因素(OR=2.73，95%CI:1.47-5.08，P=0.002)，而血漿凝血因子Ⅹ水平則是ACS的獨立危險因素(OR=3.21，95%CI:1.78-5.81，P<0.001)；③年齡、性別、吸煙、飲酒、高血壓、糖尿病、高脂血癥、腦梗死、冠心病等因素也對新發(fā)中風、ACS風險產(chǎn)生影響(P<0.05)。

結論：血漿凝血因子Ⅹ和Ⅺ水平升高與新發(fā)中風、ACS風險增加有關，血漿凝血因子Ⅺ水平是新發(fā)中風的獨立危險因素，而血漿凝血因子Ⅹ水平則是ACS的獨立危險因素，同時年齡、性別、吸煙、飲酒、高血壓、糖尿病、高脂血癥、腦梗死、冠心病等因素也對新發(fā)中風、ACS風險產(chǎn)生影響。

關鍵詞：血漿凝血因子Ⅹ；血漿凝血因子Ⅺ；新發(fā)中風；急性冠脈綜合征；多元邏輯回歸分析

Abstract：

Objective:ToinvestigatetheassociationandinfluencingfactorsbetweenplasmacoagulationfactorsXandXIlevelsandtheriskofnew-onsetstrokeandacutecoronarysyndrome(ACS).

Methods:Atotalof278new-onsetstrokeandACSpatientswereincluded,andtheirplasmacoagulationfactorsXandXIlevelsweretested.Multivariatelogisticregressionanalysiswasusedtoexploretherelationshipbetweenthetwoandtheriskofnew-onsetstrokeandACS,aswellastheirinfluencingfactors.

Results:①PlasmacoagulationfactorsXandXIlevelswerehigherinthenew-onsetstrokeandACSgroupsthaninthecontrolgroup(P<0.05);②MultivariatelogisticregressionanalysisshowedthatplasmacoagulationfactorXIwasanindependentriskfactorfornew-onsetstroke(OR=2.73,95%CI:1.47-5.08,P=0.002),whileplasmacoagulationfactorXwasanindependentriskfactorforACS(OR=3.21,95%CI:1.78-5.81,P<0.001);③Age,gender,smoking,drinking,hypertension,diabetes,hyperlipidemia,cerebralinfarction,andcoronaryheartdiseasealsohadanimpactontheriskofnew-onsetstrokeandACS(P<0.05).

Conclusion:TheincreaseinplasmacoagulationfactorsXandXIlevelsisassociatedwithanincreasedriskofnew-onsetstrokeandACS.PlasmacoagulationfactorXIisanindependentriskfactorfornew-onsetstroke,whileplasmacoagulationfactorXisanindependentriskfactorforACS.Atthesametime,age,gender,smoking,drinking,hypertension,diabetes,hyperlipidemia,cerebralinfarction,andcoronaryheartdiseasealsohaveanimpactontheriskofnew-onsetstrokeandACS.

Keywords:plasmacoagulationfactorX;plasmacoagulationfactorXI;new-onsetstroke;acutecoronarysyndrome;multivariatelogisticregressionanalysis。RecentstudieshaveshownthatplasmacoagulationfactorsXandXIplaysignificantrolesinthedevelopmentofnew-onsetstrokeandacutecoronarysyndrome(ACS).FactorXI,aproteininvolvedinbloodclotting,hasbeenfoundtoincreasetheriskofnew-onsetstroke,whilefactorXisassociatedwithanincreasedriskofACS.

However,itisimportanttoacknowledgethatotherriskfactorssuchasage,gender,smoking,drinking,hypertension,diabetes,hyperlipidemia,cerebralinfarction,andcoronaryheartdiseasealsoimpactthedevelopmentoftheseconditions.Infact,multivariatelogisticregressionanalysishasdemonstratedthatthesefactorsareindependentpredictorsofnew-onsetstrokeandACS.

Thesefindingssuggestthatacomprehensiveapproach,takingintoaccountmultipleriskfactors,isnecessaryforthepreventionandmanagementofnew-onsetstrokeandACS.FurtherresearchisneededtodeterminetheprecisemechanismsbywhichplasmacoagulationfactorsXandXIcontributetotheseconditionsandtoidentifynewtherapeutictargets。Inadditiontoidentifyingtheindependentpredictorsofnew-onsetstrokeandACS,itisimportanttoconsidertheimplicationsofthesefindingsforclinicalpractice.GiventhestrongassociationbetweenplasmacoagulationfactorsXandXIandtheseconditions,itmaybeusefultomeasurelevelsofthesefactorsinpatientsathighriskforstrokeandACS.Thiscouldhelptoidentifythosewhomaybenefitfrommoreaggressivepreventativeinterventions.

Onepotentialinterventioncouldbetheuseofanticoagulanttherapies,suchaswarfarinordirectoralanticoagulants.Thesemedicationsarecommonlyusedtopreventbloodclotsinpatientswithconditionssuchasatrialfibrillation,wherethereisanincreasedriskofstroke.However,theirroleinthepreventionofstrokeandACSinpatientswithoutatrialfibrillationislessclear.Futurestudiescouldinvestigatetheefficacyandsafetyofthesemedicationsinthispatientpopulation.

Inadditiontopharmacologicinterventions,lifestylemodificationsmayplayanimportantroleinthepreventionofnew-onsetstrokeandACS.Modifiableriskfactors,suchassmoking,hypertension,andhyperlipidemia,shouldbeaggressivelytargetedinhigh-riskpatients.Thiscouldincludesmokingcessationprograms,dietaryinterventions,andexerciseprograms.

Finally,thesefindingshighlighttheneedforamultidisciplinaryapproachtothemanagementofstrokeandACS.Inadditiontomedicalinterventions,psychologicalandsocialsupportmaybenecessarytoaddresstheemotionalandsocialconsequencesoftheseconditions.Rehabilitationandphysicaltherapymayalsobenecessarytohelppatientsrecoverfromthephysicaldisabilitiesassociatedwithstroke.

Inconclusion,theidentificationofplasmacoagulationfactorsXandXIasindependentpredictorsofnew-onsetstrokeandACShasimportantimplicationsforthepreventionandmanagementoftheseconditions.Acomprehensiveapproach,incorporatingmultipleriskfactorsandinterventions,willbenecessarytoreducetheburdenofstrokeandACSonindividualsandsocietyasawhole。Furthermore,itisimportanttorecognizetheroleoflifestylefactorsinthedevelopmentandexacerbationofstrokeandACS.Smoking,poordiet,physicalinactivity,andobesityareallmodifiableriskfactorsthatcanbeaddressedthroughtargetedinterventions.Healthcareprovidersshouldworkwithpatientstodeveloppersonalizedplansforlifestylemodificationthatincluderealisticgoalsandregularfollow-up.

Inadditiontolifestylechanges,pharmacologicinterventionscanalsoplayaroleinpreventingandmanagingstrokeandACS.AnticoagulantandantiplatelettherapieshavebeenshowntobeeffectiveinreducingtheriskofrecurrentstrokeandACS.Patientswithatrialfibrillationorotherhigh-riskconditionsmayalsobenefitfromnovelanticoagulantagents.

Finally,thepotentialforgenetictestingandpersonalizedmedicinetoimprovestrokeandACSmanagementshouldnotbeoverlooked.Asourunderstandingofthegeneticunderpinningsoftheseconditionscontinuestoadvance,itmaybecomepossibletoidentifypatientswhoareathigherriskfordevelopingstrokeorACSandtailortreatmentaccordingly.

Overall,theidentificationofplasmacoagulationfactorsXandXIasindependentpredictorsofstrokeandACSunderscoresthecomplexityoftheseconditionsandtheneedforacomprehensive,multi-facetedapproachtopreventionandmanagement.Byaddressingmodifiableriskfactors,utilizingpharmacologicinterventionswhenappropriate,andincorporatingpersonalizedtreatmentstrategies,wecanworktowardsreducingtheburdenofstrokeandACSonindividualsandsocietyasawhole。Inadditiontoaddressingmodifiableriskfactorsandpersonalizedtreatmentstrategies,itisimportanttoalsoemphasizetheimportanceofearlydetectionandinterventioninthepreventionandmanagementofstrokeandACS.Thisisespeciallytrueforindividualswhomaybeathigherriskfortheseconditions,suchasthosewithafamilyhistoryofstrokeorheartdisease,olderadults,andindividualswithcertainmedicalconditionslikehighbloodpressureordiabetes.

Regularphysicalexams,includingbloodpressureandcholesterolscreenings,canhelpidentifypotentialriskfactorsforstrokeandACS.Inaddition,individualswhoexperiencesymptomssuchaschestpain,shortnessofbreath,orsuddenonsetofnumbnessorweaknessinthefaceorlimbsshouldseekmedicalattentionimmediately,asthesecouldbesignsofaheartattackorstroke.

OnceanindividualhasbeendiagnosedwithstrokeorACS,thefocusshouldbeonprovidingprompt,appropriatetreatmenttopreventfurtherdamageandimproveoutcomes.Thismayinvolvemedicationssuchasantiplateletagentsoranticoagulants,interventionalprocedureslikestentingorangioplasty,orlifestylemodificationssuchasdietandexercise.

Overall,theidentificationofplasmacoagulationfactorsXandXIasindependentpredictorsofstrokeandACShighlightstheneedforaholisticapproachtopreventionandmanagementoftheseconditions.Bycombiningearlydetection,personalizedtreatmentstrategies,andcomprehensivecare,wecanworktowardsreducingtheimpactofstrokeandACSonindividualsandcommunities。Inadditiontotraditionalinterventions,suchasmedicationandsurgery,thereareanumberoflifestylemodificationsthatcanreducetheriskofstrokeandACS.Theseincludemaintainingahealthyweight,exercisingregularly,eatingabalanceddietwithplentyoffruitsandvegetables,avoidingtobaccoandexcessivealcoholconsumption,andmanagingstresslevels.

Physicalactivity,inparticular,hasbeenlinkedtoareducedriskofstrokeandothercardiovasculardiseases.Regularexercisecanhelplowerbloodpressure,improvecholesterollevels,enhanceinsulinsensitivity,andreduceinflammation,allofwhichareriskfactorsforstrokeandACS.

Dietalsoplaysacriticalroleinboththepreventionandmanagementoftheseconditions.Adietrichinwholegrains,fruits,vegetables,leanproteins,andhealthyfatscanlowertheriskofstrokeandACS,whilereducingintakeofsaturatedandtransfats,sodium,andaddedsugarscanhelpimproveoverallcardiovascularhealth.

Managingstressthroughtechniquessuchasmindfulnessmeditation,yoga,andrelaxationexercisescanalsohelpreducetheriskofstrokeandACS,asprolongedstresscanleadtoinflammation,highbloodpressure,andothercardiovascularriskfactors.

Inadditiontolifestylemodifications,advancesintechnologyhavealsoimprovedthepreventionandtreatmentofstrokeandACS.Forexample,theuseoftelemedicinehasallowedforremotemonitoringandmanagementoftheseconditions,particularlyinunderservedandruralareas.Additionally,newmedications,suchasPCSK9inhibitors,havebeenshowntosignificantlyreducetheriskofstrokeandothercardiovasculareventsinhigh-riskindividuals.

Overall,acomprehensiveapproachtothepreventionandmanagementofstrokeandACSinvolvesacombinationofearlydetection,personalizedtreatment,andlifestylemodifications.Byfocusingonbothtraditionalinterventionsandlifestylemodifications,wecanworktowardsreducingtheburdenofstrokeandACSinourcommunities。AnotherimportantaspectinthepreventionandmanagementofstrokeandACSispatienteducation.PatientswithahistoryofstrokeorACSneedtobeeducatedontheircondition,potentialriskfactors,andlifestylemodificationsthatcanhelpreducetheirriskoffutureevents.

SmokingcessationisanimportantlifestylemodificationthatcanhaveasignificantimpactonreducingtheriskofstrokeandACS.Smokingisamajorriskfactorforbothconditions,andquittingsmokingcanreducethisriskbyupto50%withintwoyears.Patientsshouldbeencouragedtoquitsmokingwiththehelpofcounseling,nicotinereplacementtherapy,orotherpharmacologicagents.

PhysicalactivityisanotherimportantaspectofstrokeandACSprevention.Exercisehasbeenshowntoreducetheriskofbothconditionsbyimprovingcardiovascularhealth,loweringbloodpressureandcholesterol,andreducinginflammation.Patient