摘要
目的探讨不同类型卒中的危险因素、病因、死亡原因和预后。方法基于华西医院卒中登记,脑卒中分为出血性和缺血性,缺血性卒中亚型是依据牛津郡社区卒中项目分类原则。分析住院患者的人口学特点、危险因素、死亡原因和1年末结局。结果2002年3月至2005年9月,共纳入1913例资料完整的卒中患者,其中脑出血599例(31.3%);缺血眭脑卒中1314例(68.7%)。后者中完全前循环梗死209例(15.9%),部分前循环梗死417例(31.7%),后循环梗死186例(14.2%),腔隙性梗死502例(38.2%)。校正年龄和性别,多因素分析显示,房颤是完全前循环梗死的独立预测因素(OR=1.42,95%CI=1.25~2.31);高血压和饮酒是腔隙性梗死(OR=1.24,95%CI=1.02~2.18;OR=1.12,95%CI=1.03~3.04)和脑出血(OR=1.84,95%CI:1.31~3.02;OR:1.04,95%CI=1.01~4.13)的独立预测因素。完全前循环梗死与高血压呈负相关(OR=0.62,95%CI=0.34~0.72),腔隙性梗死与房颤呈负相关(OR=0.46,95%CI=0.26~0.82),脑出血与糖尿病亦呈负相关(OR=0.56,95%CI=0.42~0.76)。以腔隙性梗死为参照,完全前循环梗死(OR:6.21,95%CI=2.86~8.42)和脑出血(OR=5.86,95%CI=2.46~8.52)明显增加患者1年死亡风险。结论不同类型卒中的危险因素、病因和结局不同。确定卒中亚型对于急性期治疗和预防有重要意义。
Objective To investigate the risk factors, pathogenesis, cause of death,and outcome of different stroke subtypes. Methods The relevant data, including demographics, baseline risk factors, cause of death, and 1-year case fatality, were analyzed among 1913 consecutive hospitalized patients with ischemic and hemorrhagic stroke, 599 (31.3%) with intracerebral hemorrhage (ICH) and 1314 with ischemic stroke (68.7%), including 209 cases ( 15.9% ) of total anterior circulation infarction ( TACI ), 417 cases (31.7%)of partial anterior circulation infarction (PACI), and 186 cases ( 14.2% ) of posterior circulation infarctions (POCI), and 502 cases (38.2%) of lacunar infarctions ( LACI), 1098 males and 815 females, aged 64 + 13 (14-98). Results Multivariate analysis showed that when age and sex were adjusted, atrial fibrillation was the independent predictive factor of TACI [ odds ratio (OR) = 1.42,95% CI = 1.25-2.31 ),hypertension and alcohol intake were the independent predictive factor LACI (OR = 1.24,95%CI=1.02-2.18;0R= 1.12,95%Cl=l.03-3.04)andICH (OR= 1.84,95%CI=1.31- 3.02 ; OR = 1.04,95% CI = 1.01 - 4.13 ). A negative association was observed between hypertension and TACI ( OR = 0.62,95% CI = 0.34 - 0.72), atrial fibrillation and LACI ( OR = 0.46,95% CI = 0.26 - 0.82), and ICH and diabetes (OR = 0.56,95% CI=0.42 -0.76). As compared to LACI, TACI and ICH significantly increased the risk of 1-year mortality ( OR = 6.21,95% CI = 2.86 - 8.42 ; OR = 5.86 ; 95% CI = 2.46 -8.52). Conclusions Stroke subtypes have different risk factor profile, causes and outcome. Information on determinants of the clinical syndromes may impact on the prevention and acute phase interventions.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2008年第13期892-897,共6页
National Medical Journal of China
关键词
危险因素
脑梗死
脑出血
结局
Risk factors
Ischemic infarction
Intracerebral hemorrhage
Outcome