青年脑出血病因及高危因素分析

Etiology and risk factors of cerebral hemorrhage in young people

目的分析和探讨青年人脑出血的病因及高危因素,为青年脑出血患者的个体化诊疗方案的制定提供理论基础。方法收集右江民族医学院附属医院2014—2019年收治的18~45岁青年脑出血患者相关信息,按照年龄划分为3组,根据欧洲SMASH-U脑出血分型对入选资料行病因及危险因素相关分析。结果542例病例中,高血压病301例(55.54%),脑血管畸形72例(13.28%),系统性疾病34例(6.27%),药物因素5例(0.92%),原因不明130例(23.99%)。18~29岁组在高血压病、脑血管畸形、不明原因类型中与其余两组差异具有统计学意义(P<0.01),在系统性疾病类型中与40~45岁组差异具有统计学意义(P<0.01)。高危因素前5位依次为高血压病(60.70%)、饮酒(42.62%)、吸烟(36.53%)、血脂异常(30.07%)、肥胖(23.43%),18~29岁组与40~45岁组5种高危因素差异均有统计学意义(P<0.01),18~29岁组与30~39岁组在高血压病、饮酒、吸烟中差异具有统计学意义(P<0.01);30~39岁组与40~45岁组在高血压病中的差异具有统计学意义(P<0.01)。结论高血压型脑出血是青年脑出血最常见类型,其次依次为病因不明型、颅内血管结构异常、系统性疾病、药物因素。高血压病、饮酒、吸烟、血脂异常、肥胖等都是青年脑出血常见的高危因素。

Objective To explore the etiology and high risk factors of cerebral hemorrhage in young people,so as to provide a theoretical basis for the formulation of individualized diagnosis and treatment programs for young patients with cerebral hemorrhage.Methods This study collected relevant information of young patients with cerebral hemorrhage,who aged 18~45 years old and were admitted to the Affiliated Hospital of Youjiang Medical University for Nationalities from 2014 to 2019.They were divided into 3 groups according to their ages.The correlation analysis of etiology and risk factors was conducted according to the European SMASH-U classification of cerebral hemorrhage.Results Among 542 cases,there were 301 cases of hypertension(55.54%),72 cases of cerebrovascular malformations(13.28%),34 cases of systemic diseases(6.27%),5 cases of drug factors(0.92%),and 130 cases of unknown causes(23.99%).There were statistically significant differences in types of hypertension,cerebrovascular malformation and unknown causes between the 18~29 years old group and the other two groups(P<0.01).The 18~29 years old group was significantly different from the 40~45 years old group in types of systemic diseases(P<0.01).The top five risk factors were hypertension(60.70%),drinking(42.62%),smoking(36.53%),dyslipidemia(30.07%)and obesity(23.43%).There were statistically significant differences in the five risk factors between the 18~29 years old group and the 40~45 years old group(P<0.01),and significant differences were also found in hypertension,drinking and smoking between the 18~29 years old group and the 30~39 years old group(P<0.01).The difference in hypertension between the 30~39 years old group and the 40~45 years old group was statistically significant(P<0.01).Conclusion Hypertensive cerebral hemorrhage is the most common type of cerebral hemorrhage in young people,followed by unknown etiology,abnormalities of intracranial vascular structure,systemic diseases,and drug factors.Hypertension,drinking,smoking,dyslipidemia and obesity are common risk factors for cerebral hemorrhage in young people.