青年与中老年急性脑出血的危险因素及预后比较

Risk Factors and Prognosis of Acute Cerebral Hemorrhage of Young and Middle-senile Age

目的比较青年与中老年发生急性脑出血的危险因素及其预后。方法回顾性分析我院2002年1月—2009年1月神经外科住院的急性脑出血患者的临床资料,符合入选标准及排除标准者共786例,根据年龄分为青年组(年龄≤45岁)310例和中老年组(年龄>45岁)476例,对其相关危险因素进行比较分析,并分析两组急性脑出血患者的住院病死率和1年病死率。结果高血压是脑出血发病的危险因素,中老年组高血压发病率更高,两组比较差异有统计学意义(P<0.05)。高脂血症是中老年脑出血发病的危险因素,而吸烟史、大量饮酒史是青年脑出血发病的危险因素,两组比较差异有统计学意义(P<0.05)。高血压、动静脉畸形及动脉瘤破裂是青年脑出血的主要原因,高血压是中老年脑出血的主要原因。青年组和中老年组患者的住院病死率和1年病死率间差异有统计学意义(P<0.05)。结论高血压是各年龄组脑出血发病的最重要的危险因素;高脂血症是中老年脑出血发病的危险因素,而吸烟史、大量饮酒史是青年脑出血的危险因素。预后主要与年龄、出血部位和出血量有关,年龄>45岁,出血量大或出血发生在脑干、丘脑部位的患者预后差。

Objective To compare the risk factors and prognosis of patients with acute cerebral hemorrhage in young and middle-senile age groups.Methods Seven hundred eighty-six acute cerebral hemorrhage patients were divided into groups young （aged≤45,n=310 ） and middle-senile （aged 45,n=476）.The risk factors,inhospital and 1 y death rate were analyzed.Results Hypertension was the risk factor of cerebral hemorrhage,more common in middle-senile group,the difference was significant （P〈0.05）.Hyperlipidemia was risk factor of cerebral hemorrhage in middle-senile group,but smoking history,heavy drinking was the risk factor in young people,the difference was significant （P〈0.05）.Hypertensive cerebral hemorrhage,arteriovenous malformation （AVM） and aneurysm rupture were the main reason in youth group,but hypertension was in middle-senile group.There was significant difference in inhospital and 1 year death rate between 2 groups （P〈0.05）.Conclusion Hypertension is the most important risk factor of cerebral hemorrhage in all age groups.Hyperlipidemia is a risk factor in middle-senile group,and smoking,heavy drinking are risk factors in youth group.Prognosis,related to age,hemorrhagic sites and volume,is bad in patients aged〉45 years old,big bleeding amount or hemorrhage in brain stem or thalamus.