体检人群新发脑出血相关危险因素分析——一项来自社区的观察性研究

Analysis of Clinical Characteristics and Risk Factors of New-onset Intracranial Hemorrhage: a Large Prospective Community-based Study

目的分析我国北方体检人群中新发脑出血相关危险因素及特征。方法连续性纳入2006年6月-2007年10月开滦社区的体检者,基线期完善问卷调查、体格检查及实验室检查。每24个月对所有受检者进行一次面对面随访,截至2015年12月31日,记录所有受检者随访期间新发卒中事件类型及时间。将脑出血组和对照组的一般临床资料、既往病史、体检、实验室检查结果等进行比较,采用Cox比例风险回归模型评估新发脑出血的预测因子并进行分析。结果研究最终纳入受检者94 993例,随访期间发生卒中事件者3568例(3.8%),其中脑出血事件者746例(0.8%)。在脑出血患者中,男性、高龄、低收入、低学历、高BMI、高血压、糖尿病、脂代谢紊乱和心房颤动病史与对照组相比,差异具有统计学意义(P<0.05)。校正相关因素后,高收缩压(HR1.026,95%CI 1.018~1.035,P<0.0001)、高舒张压(HR 1.040,95%CI 1.026~1.055,P<0.0001)与高血糖(HR 1.127,95%CI 1.046~1.215,P=0.0017)是新发脑出血事件的独立危险因素。结论男性、高龄、低收入、低学历、高BMI、脂代谢紊乱、高血压和糖尿病均可增加脑出血风险,其中高血压和高血糖水平是脑出血的独立危险因素。

Objective To investigate the clinical characteristics and risk factors for new-onset intracranial hemorrhage(ICH)among physical examination population in Northern China.Methods Basic data of physical examination people in Kailuan community from June 2006 to October 2007 were collected by questionnaires,physical examination and laboratory examination.A face-to-face follow-up for all subjects were taken every 24 months,until the end of 2015.The newonset stroke during the whole follow-up were recorded.Comparing the relevant data between the new-onset ICH group and the control group,cox regressive analysis was used to assess the relevant factors of new-onset hemorrhagic stroke.Results A total of 94 993 participants without a history of stroke completed the follow-up and were included in the final analysis.Stroke occurred in 3568(3.8%)participants during the followup,including 746(0.8%)ones with intracranial hemorrhage.There were significant difference in the percentage of male,old age,low income,low level of education,high BMI,and history of hypertension,diabetes,hyperlipidemia,atrial fibrillation between the hemorrhage group and the control group,and all the above rates were higher in the ICH group(P<0.05).After adjusting for the confounding factors,high systolic blood pressure(HR 1.026,95%CI 1.018-1.035,P<0.0001),high diastolic blood pressure(HR 1.040,95%CI 1.026-1.055,P<0.0001)and high glucose(HR 1.127,95%CI 1.046-1.215,P=0.0017)were all the independent risk factors of intracranial hemorrhage.Conclusions Male,old age,low income,low level of education,high BMI and hyperlipidemia,hypertension,diabetes were related with the risk of ICH,of which hypertension and high glucose were the independent risk factors of ICH.