华东地区缺血性与出血性脑卒中危险因素对比研究

Risk factors in the patients with ischemic stroke or hemorrhagic stroke in East China

目的探讨各种危险因素与华东地区脑卒中发病风险的关系，并对缺血性脑卒中与出血性脑卒中的危险因素进行对比，为脑卒中的个体化预防提供科学依据。方法收集华东地区脑卒中病例692例，其中缺血性脑卒中540例，出血性脑卒中152例。对两种脑卒中类型的多种危险因素进行描述性对比分析研究。结果与出血性脑卒中比较，缺血性脑卒中更密切相关的危险因素依次是脑卒中家族史、肥胖、颈总动脉斑块、房颤病史、高纤维蛋白原、短暂性脑缺血发作史、颈内动脉斑块、冠心病史、低高密度脂蛋白、年龄增大、糖尿病史、性别（男）；仅血白细胞升高、高血压病史和高血压家族史与出血性脑卒中有更显著的相关性。结论对于华东地区来说，高血压和脉压增大是脑卒中最突出的危险因素，其次为高胆固醇血症。缺血性脑卒中和出血性脑卒中的危险凼素并不完全一致。

Objective To investigate the relationship between various risk factors and stroke in East China and to identify the risk factors for ischemic stroke and hemorrhagic stroke. Methods 692 cases, consisting of 540 ischemic stroke and 152 hemorrhagic stroke from East China were included in this study. The related factors of stroke subtype were collected and analyzed. Results The factors were significantly associated with ischemic stroke as opposed to hemorrhagic stroke were family history of stroke, followed by obesity, atherosclerotic plaque of common carotid artery, atrial fibrillation, hyperfibrinogenemia, transient ischemic attack （TIA）, atherosclerotic plaque of internal carotid artery, coronary heart, lower high- density lipoproteins, increasing age, diabetes mellitus, gender（male）. Leukocytosis, hypertension and family history of hypertension were the significant factors associated with hemorrhagic stroke versus ischemic stroke. Conclusion The most prominent factors for overall stroke in Ease China were hypertension, followed by higher pulse pressure and hypercholesterolemia. The risk factors for ischemic stroke and hemorrhagic stroke are not the same.