内蒙古自治区7472例脑卒中发病流行病学特征分析

Epidemiological characteristics of 7 472 cases of stroke in Inner Mongolia Autonomous Region

目的 分析内蒙古地区缺血性和出血性脑卒中发病流行病学特点及相关因素,为脑卒中高危人群的防治策略制定提供数据支撑。方法 选取国家脑卒中高危人群筛查和干预项目2020年度内蒙古地区医院7 472例脑卒中患者的数据,对病例基本特征、临床检测指标、实验室检测指标等应用SPSS 22.0统计软件进行χ2检验和t检验,采用多因素logistic回归计算出血性和缺血性脑卒中的比值比(OR)及其95%可信区间(95%CI)。结果 内蒙古地区脑卒中发病以缺血性为主,占比89.7%,且男性高发。缺血性脑卒中组糖尿病患病率明显高于出血性脑卒中组,差异有统计学意义(P<0.01),而出血性脑卒中组高血压患病率明显高于缺血性脑卒中,差异有统计学意义(P<0.01)。单因素分析,缺血性脑卒中组的体质指数(BMI)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及同型半胱氨酸(Hcy)水平明显高于出血性脑卒中组,差异有统计学意义(P<0.01),而高密度脂蛋白胆固醇(HDL-C)水平明显低于出血性脑卒中组,差异有统计学意义(P<0.01)。缺血性脑卒中组各年龄组BMI均大于出血性脑卒中组,差异均有统计学意义(P<0.01)。多因素回归分析显示,相对于出血性脑卒中,缺血性脑卒中的影响因素为年龄、BMI、高TC、低HDL-C、高Hcy、吸烟史和糖尿病;而相对于缺血性脑卒中,出血性脑卒中的影响因素为高血压、蒙古族和饮酒情况。汉族人群中年龄、BMI、TC、HDL-C、Hcy水平、吸烟(史)和过量饮酒、高血压和糖尿病患病情况等是两类脑卒中的影响因素(P<0.05);而蒙古族人群TG、HDL-C及饮酒情况不是发生两类脑卒中的影响因素(P>0.05)。结论 内蒙古地区脑卒中发病以缺血性为主,男性高发。糖尿病、BMI、血脂异常(高TC、低HDL-C和高Hcy)和高龄与缺血性脑卒中关系密切。低龄、高血压、饮酒及蒙古族人群更易发生出血性脑卒中。

Objective To analyze the epidemiological characteristics of ischemic stroke and hemorrhagic stroke and related risk factors in Inner Mongolia, and provide data support for the development of stroke prevention and treatment strategies in high-risk population in this region. Methods The data of 7 472 stroke patients in hospitals in Inner Mongolia in 2020 from the national project “screening of stroke high-risk groups and intervention” were selected. The basic characteristics, clinical test indexes and laboratory test indexes of the cases were tested by χ2 test and t-test with statistical software SPSS 22.0,Multivariate logistic regression analysis was used to calculate the odds ratio(OR) and 95% confidence interval(95% CI) of hemorrhagic and ischemic stroke. Results Ischemic stroke was the main type of stroke in Inner Mongolia, accounting for89.7%, and the incidence was high in men. The prevalence of diabetes in ischemic stroke group was significantly higher than that in hemorrhagic stroke group, the difference was statistically significant(P<0.01), and the prevalence of hypertension in hemorrhagic stroke group was significantly higher than that in ischemic stroke group, the difference was statistically significant(P<0.01). Univariate analysis showed that the body mass index(BMI), serum total cholesterol(TC), low density lipoprotein cholesterol(LDL-C) and homocysteine(Hcy) levels in ischemic stroke group were significantly higher than those in hemorrhagic stroke group, the difference was statistically significant(P<0.01), while the level of high density lipoprotein cholesterol(HDL-C) was significantly lower than that in hemorrhagic stroke group, the difference was statistically significant(P<0.01). The BMI of ischemic stroke group was higher than that of hemorrhagic stroke group in all age groups, the difference was statistically significant(P<0.01). Multivariate regression analysis showed that the related factors for ischemic stroke were age, BMI, high TC, low HDL-C, high Hcy, smoking history and suffering from diabetes compared with hemorrhagic stroke. Compared with ischemic stroke, the influencing factors for hemorrhagic stroke were suffering from hypertension, being Mongolian and drinking. Age, BMI, TC level, HDL-C level, Hcy level, smoking history, excessive alcohol consumption, and suffering from hypertension and diabetes were the influencing factors for two types of stroke in Han population(P<0.05). The levels of TG, HDL-C and alcohol consumption were not the influencing factors for two types of stroke in Mongolian population(P>0.05). Conclusion Ischemic stroke was the main type of stroke in Inner Mongolia, the incidence was high in men. Diabetes, BMI, dyslipidemia(high TC, low HDL-C and high Hcy) and old age were closely associated with the incidence of ischemic stroke. Young people, people with hypertension and alcohol consumption, and Mongolian were more likely to have hemorrhagic stroke.