脑出血青年患者的致病原因与相关因素研究

The causes of cerebral hemorrhage and related factors in young patients

目的探究脑出血青年患者的致病原因与相关因素。方法选取2016年1月至2019年1月期间永康市第一人民医院收治的288例脑出血青年患者的临床资料,设为观察组,并选取同期进行健康检查的288名健康志愿者作为对照组,分析脑出血青年患者的致病原因,并采用单因素和多因素logistic分析脑出血青年患者致病的相关因素。结果脑出血青年患者发病的主要原因为高血压,其次为原因不明血管畸形。单因素分析结果显示,观察组与对照组患者的吸烟、饮酒、高血压、高乳酸脱氢酶(lactic dehydrogenase,LDH)血脂、心脑血管病家族史、糖尿病、空腹血糖(fasting blood glucose,FBG)、体质量指数(body mass inedx,BMI)、糖化血清蛋白(glycosylated serum protein,GSP)、高密度脂蛋白胆固醇(high density liptein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density liptein cholesterol,LDL-C)、血三酰甘油(triglycerides,TG)、血总胆固醇(total cholesterol,TC)、舒张压(diastole pressure,DBP)、收缩压(systolic blood pressure,SBP)、胰岛素抵抗指数(homeostasis model insulin resistance,HOMA-IRI)、血肌酐(serum creatinine,CRE)、D-二聚体(D-Dimer,D-D)、血尿酸(uric acid,UA)、血同型半胱氨酸(homocysteine,HCY),水平比较差异有统计学意义(P<0.05)。Logistic多因素分析结果显示,饮酒、高血压、高LDH血脂、糖尿病、高HCY、高FBG、高TG为脑出血青年患者发病的危险因素(P<0.05)。结论脑出血青年患者发病的主要原因为高血压和血管畸形,应加强对饮酒、高血压、高LDH血脂、糖尿病、高HCY、高FBG、高TG人群的监测,以降低脑出血发病率。

Objective To discuss the causes of cerebral hemorrhage and related factors in young patients. Methods 288 young patients with cerebral hemorrhage admitted to the First People′s Hospital of Yongkang from January 2016 to January 2019 were enrolled into our study observation group, and 288 healthy volunteers were recruited as study controls.The causes of cerebral hemorrhage in young patients were discussed and the related factors were analyzed by single factor and multivariate logistic models. Results The leading cause of cerebral hemorrhage in young patients was hypertension, followed by unexplained vascular malformations.Univariate analysis showed that the differences in smoking, alcohol consumption, hypertension, high LDH, family history of cardiovascular and cerebrovascular diseases, diabetes, FBG, GSP, HDL-C, TG, SBP, HOMA-IRI, DD, HCY were significant between the two groups(P<0.05).Multivariate logistic analysis showed that alcohol consumption, hypertension, high LDH, diabetes, high HCY, high FBG and high TG were risk factors for cerebral hemorrhage in young patients(P<0.05). Conclusions The two major causes of cerebral hemorrhage in young patients are hypertension and vascular malformation, and many factors involve, therefore monitor for drinking, hypertension, LDH, diabetes, HCY, FBG and TG should be strengthened to reduce the incidence of cerebral hemorrhage.