北京与京外地区青年卒中临床特点对照研究

The Comparison of the Incidence and the Knowledge about Stroke in Young between Beijing and out of Beijing

目的比较北京与京外地区18～45岁青年卒中的危险因素、发病情况及两组人群对卒中的认识情况,达到提高一级预防青年卒中的效果。方法收集2006年北京21所三甲医院卒中住院患者1214例,同期京外地区12所三甲医院卒中住院患者1056例。调查内容包括年龄、性别、居住地、文化程度、职业、生活习惯、常规危险因素、对卒中的认识、临床诊断及转归等。结果(1)在所调查的人群中,北京地区青年卒中的比例低于京外(4.5%vs7.9%,P<0.05)。居住市区、在职人员、男性等在青年卒中所占的比例较高,两组之间无统计学差异(北京地区分别为:60.0%,65.5%,81.8%;京外地区分别为:63.8%,59.0%,69.9%,P<0.05)。(2)北京地区青年卒中亚型的各构成比前3位分别为:缺血性卒中、脑出血、短暂性脑缺血发作。京外地区为:缺血性卒中、脑出血、蛛网膜下腔出血。(3)北京和京外地区青年卒中发病的危险因素前3位均为:高血压、吸烟、大量饮酒。(4)两组超过一半的患者发病当时即治疗(北京72.7%,京外56.6%,P>0.05)。两组患者接受溶栓、超过溶栓时间的比例、高危个体的知晓无统计学差异(北京地区分别为9.1%,29.1%,29.1%;京外地区分别为4.8%,31.3%,16.9%,P>0.05)。北京地区和京外地区青年卒中住院期间病死率差异无统计学意义(3.6%vs1.2%,P>0.05)。结论(1)北京和京外地区居住市区的在职男性青年卒中在卒中中所占的比例较高。(2)高血压、吸烟和大量饮酒是两组青年卒中发病的重要危险因素。(3)两组青年卒中的发病类型均以缺血性卒中和脑出血为主。(4)两组青年卒中住院期间的病死率均较低。(5)两组患者对卒中知识的了解均较少。

Objective To find measures to prevent the young stroke through comparison of the incidence and the knowledge about stroke between Beijing and out of Beijing.Methods Total 1214 stroke patients from the 3A grade hospitals of Beijing and 1056 stroke patients from the 3A grade hospitals out of Beijing were recruited.We collected the data including age,sex,habitation,education,occupation,hypertension history,heart diseases history,diabetes history,smoking,drinking alcohol,incidence state,blood lipids,clinical diagnosis and prognosis and so on.Results 1.There were 55 and 83 young patients less than 45-year-old suffered stroke in Beijing and out of Beijing respectively.The young stroke constituent ratio in Beijing was significantly lower than that out of Beijing(4.5%vs7.9%,P<0.05).The constituent ratio in living in urban field,on the job,and male of young stroke were higher in both groups,but there were no significant difference between them(Beijing group was:60.0%,65.5%,81.8%,respectively;Out of Beijing group was:63.8%,59.0%,69.9%,respectively,P>0.05).2.The young stroke subtypes were ischemic stroke,intracerebral hemorrhage(ICH),transient ischemic attack(TIA)in Beijing and ischemic stroke,ICH,subarachnoid hemorrhage(SAH) out of Beijing.3.The first three risk factors of young stroke were hypertension,smoking,drinking alcohol in both two groups.4.More than half of the young stroke patients in two groups went to hospital in 1h after onset,but there was no significantly different between them(72.7% vs 56.6%,P>0.05)).The rates of accepting thrombolysis,beyond the time of thrombolysis and knowing as a high risk individual were no significant difference between Beijinggroup and out of Beijing group(9.1% vs 4.8%,P>0.05;29.1%vs 31.3%16.9%,P>0.05;29.1% vs16.9%,P>0.05,respectively).The death rate were 3.6% and 1.2% in Beijing and out of Beijing respectively.Conclusion 1.The higher constituent ratio is happened in male,living urban field and on the job of young stroke in two groups.2.Hypertension,smoking and drinking are the important risk factors in both two groups.3.The young stroke subtypes are ischemic stroke and intracerebral hemorrhage in two groups.4.The lower death rate happens in young stroke patients in Beijing and out of Beijing.5.The young patients with stroke in two groups know a few of knowledge about stroke.