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研究生： 德樂沙
Theresa - Lalita Handaruputri
論文名稱： 從健檢資枓庫研究慢性腎臟疾病和缺血性中風之間的關聯
Investigating Association between Chronic Kidney Disease and Ischemic Stroke from a Health Examination Dataset
指導教授： 歐陽超
Chao Ou-Yang
口試委員: 王孔政
Kung-Jeng Wang
陳 杰峰
Chieh-Feng Chen
學位類別： 碩士
Master
系所名稱： 管理學院 - 工業管理系
Department of Industrial Management
論文出版年： 2017
畢業學年度： 105
語文別： 英文
論文頁數： 72
中文關鍵詞： 缺血性中風 、慢性腎病 、混雜因素 、流行率 、優勢比
外文關鍵詞： Ischemic stroke, chronic kidney disease, confounding factors, prevalence rate, odds ratio
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    • 在過去四十年中，中風已成為台灣三大死因之一。台灣最常見的中風類型是缺血性中風。慢性腎臟疾病（CKD）是另一個重要的死亡原因。目前台灣在世界各地的終末期腎病發病率最高。因為慢性腎臟疾病和缺血性中風共有幾個傳統的心血管危險因素, 重要的是看到慢性腎臟疾病和缺血性中風之間的關聯的性質。這項研究解決了缺血性卒中和慢性腎臟疾病之間的關係的流行率和比值比的問題。關聯測量考慮了顯著混雜的危險因素對缺血性卒中和慢性腎臟疾病之間的關聯的影響。糖尿病，高血壓，高膽固醇血症和高甘油三酯血症成為缺血性卒中和慢性腎臟疾病之間的聯繫的混雜因素。混雜因素的存在增加了患有慢性腎臟疾病的受試者的中風的可能性，並且在沒有慢性腎臟疾病的受試者中減少。

    In the past four decades, stroke has become one of top three leading causes of death in Taiwan, with the most common type of stroke in Taiwan was ischemic stroke compared to hemorrhagic stroke. Chronic kidney disease (CKD) is also another important cause of death. Taiwan currently has the highest incidence rates of end-stage renal disease throughout the world. Since CKD and stroke share several traditional cardiovascular risk factors, it is needed to see the nature of association between CKD and ischemic stroke in the existence of shared risk factors. This study addresses the issue of association between ischemic stroke and CKD in terms of prevalence rate and odds ratio. The measurement of association considered the effects of significant confounding risk factors in the association between ischemic stroke and chronic kidney disease. Diabetes, hypertension, hypercholesterolemia, and hypertriglyceridemia became the confounders for the association between ischemic stroke and chronic kidney disease. The presence of confounders increases the likeliness of stroke in subjects with chronic kidney disease, and decreases it in subjects without chronic kidney disease.

    Master’s Thesis Recommendation Formii Qualification Form by Master’s Degree Examination Committeeiii ABSTRACTiv 中文摘要v ACKNOWLEDGEMENTvi TABLE OF CONTENTSvii LIST OF FIGURESx LIST OF TABLESxii CHAPTER I INTRODUCTION1 1.1.Background1 1.2.Purpose2 1.3.Research Structure2 CHAPTER II LITERATURE REVIEW3 2.1.Ischemic Stroke3 2.2.Chronic Kidney Disease4 2.3.Prevalence5 2.4.Odds Ratio6 2.4.1.Confounding Variable7 2.4.2.Mantel-Haenszel Procedure9 2.4.3.Generalized Linear Models10 CHAPTER III RESEARCH METHODS11 3.1.Research Framework11 3.1.1.Data Collection11 3.1.2.Data Preprocessing11 3.1.3.Study of Demographic and Biochemical Characteristics of Study Subject13 3.1.4.Study of Risk Factors Correlated with Ischemic Stroke13 3.1.5.Association between Chronic Kidney Disease and Ischemic Stroke14 3.2.Statistical Analysis14 CHAPTER IV RESULTS AND DISCUSSION16 4.1.Data Collection16 4.2.Data Preprocessing19 4.3.Demographics of the Study Subjects20 4.4.Risk Factors Correlated with Ischemic Stroke21 4.5.Association between Ischemic Stroke and Chronic Kidney Disease (CKD) in Various Age Ranges24 4.5.1.Prevalence Rate of Ischemic Stroke in Subjects with and without Chronic Kidney Disease (CKD) in Crude Measurement24 4.5.2.Odds Ratio of Ischemic Stroke in Subjects with and without Chronic Kidney Disease (CKD) in Crude Measurement25 4.5.3.Adjustment for Significant Confounding Factors27 4.5.4.Prevalence Rate of Ischemic Stroke in Chronic Kidney Disease Patient (CKD) in Hypertension and No Hypertension Strata29 4.5.5.Odds Ratio of Ischemic Stroke in Chronic Kidney Disease Patient (CKD) in Hypertension and No Hypertension Strata31 4.5.6.Comparison of Crude Odds Ratio and Adjusted Odds Ratio of Ischemic Stroke by Hypertension34 4.5.7.Prevalence Rate of Ischemic Stroke in Chronic Kidney Disease Patient (CKD) in Diabetes and No Diabetes Strata36 4.5.8.Odds Ratio of Ischemic Stroke in Chronic Kidney Disease Patient (CKD) in Diabetes and No Diabetes Strata37 4.5.9.Comparison of Crude Odds Ratio and Adjusted Odds Ratio of Ischemic Stroke by Diabetes40 4.5.10.Prevalence Rate of Ischemic Stroke in Chronic Kidney Disease Patient (CKD) in Hypertriglyceridemia and No Hypertriglyceridemia Strata42 4.5.11.Odds Ratio of Ischemic Stroke in Chronic Kidney Disease Patient (CKD) in Hypertriglyceridemia and No Hypertriglyceridemia Strata43 4.5.12.Comparison of Crude Odds Ratio and Adjusted Odds Ratio of Ischemic Stroke by Hypertriglyceridemia45 4.5.13.Prevalence Rate of Ischemic Stroke in Chronic Kidney Disease Patient (CKD) in Hypercholesterolemia and No Hypercholesterolemia Strata47 4.5.14.Odds Ratio of Ischemic Stroke in Chronic Kidney Disease Patient (CKD) in Hypercholesterolemia and No Hypercholesterolemia Strata48 4.5.15.Comparison of Crude Odds Ratio and Adjusted Odds Ratio of Ischemic Stroke by Hypercholesterolemia51 4.5.16.Comparison of Crude and Adjusted Odds Ratio of Ischemic Stroke53 CHAPTER V CONCLUSIONS AND FUTURE RESEARCH55 5.1.Conclusion55 5.2.Future Research56 REFERENCE57

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