不同类型卒中患者危险因素分布特征研究  

Distributional Characteristics of Risk Factors in Different Types/TOAST Subtypes of Stroke

作　　者：安中平[1] 段建钢[1] 王景华[2] 宁宪嘉[2] 

机构地区：[1]天津市环湖医院神经内科,天津300060 [2]天津市神经病学研究所流行病学研究室、天津医科大学总医院神经内科,天津300052

出　　处：《中国慢性病预防与控制》2010年第4期380-382,共3页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：天津市科委科技支撑计划重点项目(07ZCGYSF02800)

摘　　要：目的对脑梗死、脑出血及不同亚型脑梗死的危险因素进行比较。方法前瞻性登记2007年1月1日—2008年5月31日于天津市环湖医院卒中单元病房入院的脑卒中患者1257例,收集相关的危险因素,对所有的缺血性脑卒中患者进行TOAST病因分型,比较不同类型脑卒中患者的常见危险因素。结果男性在脑出血和脑梗死中所占的比重(分别为71.0%,61.8%)高于女性(29%,38.2%),但心源性脑栓塞女性占多数(54.5%)。男性更容易发生脑出血(P=0.008)。脑出血组的平均发病年龄([60.87±12.041)岁]低于脑梗死([64.54±11.595)岁],差别有统计学意义(P<0.05)。脑出血组高血压、酗酒的发生率高于脑梗死,差别有统计学意义(P<0.05)。脑梗死组吸烟、糖尿病、高脂血症、高同型半胱氨酸血症、心房纤颤和久坐生活方式的发生率均高于脑出血,差别有统计学意义(P<0.05)。高血压、脑动脉狭窄和高同型半胱氨酸血症在大动脉粥样硬化性卒中的发生率最高,糖尿病在小动脉卒中的发生率最高,心房纤颤在心源性脑栓塞中的发生率最高。高脂血症、吸烟、酗酒和肥胖在不同亚型脑梗死中所占的比重无明显差异。肥胖在不同类型卒中的发生率无明显差异。结论脑梗死、脑出血和不同亚型脑梗死的危险因素不尽相同。高血压是各类脑卒中的最重要危险因素,高同型半胱氨酸血症是大动脉粥样硬化的重要危险因素。在脑卒中的防治工作中,应该考虑不同因素对不同亚型卒中的影响。Objective To estimate the frequency of various risk factors for cerebral infarction （CI）, cerebral hemorrhage （CH） and different subtypes of cerebral infarction in a special neurological hospital, Tianjin. Methods 1 257 inpatients with stroke were registered and collected from Jan. 1, 2007 to May 31, 2008. All isehemic stroke patients were classified as TOAST. The common risk factors were evaluated among various types of stroke patients. Results The proportions of male were higher than those of female in the CH （71.0% vs. 29%） and CI （61.8% vs. 38.2%）. However, the proportion of female was higher than male in cardioembolic stroke. Man suffered from CH easier than woman did. The mean age of onset in CH （60.87±12.041 yrs） was lower than that in CI （64.54±11.595 yrs）. The incidence rates of hypertension and heavy drinking were higher in CH than in CI. The rates of cigarette smoking, diabetes, hyperlipidemia, hyperhomocysteinaemia, atrial fibrillation and low physical activity were higher in CI than CH. The rates of hypertension, cerebral arteries stenosis and hyperhomocysteinaemia were the highest in large-artery atherosclerosis stroke （LAA）. The rate of diabetes was the highest in small-artery occlusion stroke. The rate of atrial fibrillation was the highest in eardioembolic stroke. The rates of hyperlipidemia, cigarette smoking, heavy drinking and obesity had no significant difference among distinct subtypes of CI. The rate of obesity had no significant difference between the two types of stroke. Conclusion The distribution of risk factors for CI, CH and different subtypes of CI are not completely same. Hypertension is the most important risk factor for overall stroke. Hyperhomocysteinaemia is an important risk factor for LAA.

关 键 词：脑梗死 脑出血 危险因素 TOAST分型 

分 类 号：R743.3[医药卫生—神经病学与精神病学]