珠海市416例青年脑卒中病因和危险因素分析

Analysis of etiology and risk factors of stroke among young patients in Zhuhai

目的了解珠海市青年脑卒中的病因和危险因素。方法回顾当地两家医院首次脑卒中青年的住院病历资料,分析病因构成,与健康对照比较危险因素并做单因素和多因素logistic回归分析。结果纳入18～45岁的脑卒中416例,225例缺血性卒中的病因分别是动脉粥样硬化占40.00%,高血压19.55%,心源性栓塞6.67%,高黏血症4.89%,脑血管炎、产褥期和白血病少见,病因不明26.67%;183例出血性卒中的病因分别为高血压34.43%,动脉粥样硬化27.87%,动静脉畸形7.10%,高黏血症、动脉瘤和脑血管炎少见,病因不明达50.82%;8例混合型卒中,4例病因为高血压,4例病因不明。40～45岁(OR=1.587,95%CI:1.528～1.974)、男性(OR=1.208,95%CI:1.107～1.326)、血脂异常(OR=1.013,95%CI:1.004～3.041)、高血压(OR=19.623,95%CI:8.777～43.870)、吸烟(OR=2.099,95%CI:1.157～3.808)和饮酒(OR=2.099,95%CI:1.114～8.694)是独立危险因素。结论珠海市青年脑卒中的病因多样,以动脉粥样硬化、高血压和隐源性为主,接近中年、男性、血脂异常、高血压、吸烟和饮酒是主要危险因素。

Objective To understand the etiology and risk factors of stroke among young patients in Zhuhai.Methods Clinical data for a total of 416 patients aged from 18 to 45 years who were admitted into two public hospitals for a first-ever occurrence of stroke from July 2002 to July 2009 was retrospectively reviewed.The etiological factors of stroke were analyzed and risk factors were determined by univariate and multiple logistic regression analysis.Results The most frequent stroke etiological factors among 225 patients with ischemic stroke were atherosclerosis（40.00%）,hypertension（19.55%）,cardiogenic embolism（6.67%） and blood hyperviscosity（4.89%）,while hypertension（34.43%）,atherosclerosis（27.87%）,anteriovenous malformation（7.10%） were found to be the major causes of stroke among 183 hemorrhagic stroke patients.There were certain numbers of patients with unknown causes of stroke.Also hypertension highly accounted for the occurrence of mixed stroke（4 out of 8 patients）.Our analysis also revealed that 40-45 years old（OR：1.587,95% CI：1.528-1.974）,male（OR：1.208,95% CI：1.107-1.326）,dyslipidemia（OR：1.013,95% CI：1.004-3.041）,hypertension（OR：19.623,95% CI： 8.777-43.870）,smoking（OR：2.099,95% CI：1.157-3.808） and drinking（OR：2.099,95% CI：1.114-8.694） were independent risk factors of stroke.Conclusions Although the etiology of stroke among young patients in Zhuhai is heterogeneous,atherosclerosis and hypertension are the most common causes and age,gender,dyslipidemia,hypertension,smoking and drinking are the primary risk factors of stroke.