缺血性和出血性脑卒中危险因素分析

Analysis on risk factors between ischemic and hemorrhagic stroke

目的:探讨不同危险因素对缺血性和出血性脑卒中发病的影响程度。方法:收集612例(366例缺血性和246例出血性)脑卒中患者的人口学、个人疾病史、生活方式、临床检查及生化指标结果等资料,用Epidata软件建立数据库,采用SPSS 13.0进行统计分析。结果:出血性脑卒中患者的收缩压、舒张压、尿血酸、纤维蛋白原水平、高血压和高血糖的比例均高于缺血性脑卒中患者,差异有统计学意义(t/χ2=9.051、14.314、8.573、11.143、39.854和4.954,P均<0.05);缺血性脑卒中患者的甘油三酯和高密度脂蛋白水平以及吸烟、肥胖和房颤的比例高于出血性脑卒中患者,差异有统计学意义(t/χ2=7.360、2.116、5.778、4.965和14.553,P均<0.05);相对出血性脑卒中,与缺血性脑卒中显著相关的因素有房颤、肥胖、高甘油三酯、脑卒中史、脉压增大、年龄>60岁和高尿酸(OR=3.564、3.452、2.364、1.978、1.512、1.322和1.315,P均<0.05),高血压是出血性脑卒中危险因素(OR=0.689,P<0.001)。结论:高血压是出血性脑卒中患者主要危险因素,相对出血性脑卒中,与缺血性脑卒中发病密切的危险因素是房颤、肥胖、高甘油三酯、脑卒中病史、脉压增大、年龄>60岁和高尿酸等。

Aim： To explore the degree of various risk factors and difference between ischemie and hemorrhagic stroke. Methods：Data for demography, disease history, life style, clinical and biochemical examination, were collected from 612 patients with ischemic or hemorrhagic stroke. Epidata software was used to set up database, and SPSS 13.0 was used to analyze the data. Results： Means of SBP, DBP, uric acid,fibrinogen and the frequency of hypertension and high blood sugar patients with hemorrhagic stroke were higher than those patients with isehemic stroke, had obvious differences （t/x2 =9.051,14.314,8.573,11.143,39.854,4.954,P〈0.05）. Means of TC,HDL-e,andthe frequency of smoking, o- besity, atrial fibrillation in ischemic stroke patients were higher than those hemorrhagic stroke patients, had obvious diffenc- es （ t/X2 = 7. 360,2.116,5. 778,4. 965 and 14. 553, P 〈 0.05 ）. By multivariate analysis, the factors significantly associated with hemorrhagic stroke isehemic compared with stroke were atrial fibrillation, followed by obesity, hypertriglyeeridemia, history of stroke, increasing pulsant pressure, increasing age and high uric acid（ OR = 3. 564,3. 452,2. 364, l. 978,1. 512, 1. 322 and 1. 315 ,P 〈 O. 05 ）. Hypertension was the only significant factor associating with hemorrhagic stroke（ OR = 0. 689, P 〈 O. 001 ）. Conclusion：Hypertension is the most important risk factor for hemorrhagic stroke. Atrial fibrillation, obesity, hypertriglyeeridemia, history of stroke, increasing pulsant pressure, increasing age and high uric acid should be the most powerful factors associated with ischemie stroke rather than hemorrhagic stroke.