不同危险因素在脑梗死和脑出血患者中的分布差异和作用  

Distribution difference and role of different risk factors in patients with cerebral infarction and cerebral hemorrhage

作　　者：王景[1] 何超明[1] 刘娜[2] 吉晓天 

机构地区：[1]海南省农垦三亚医院神经内科,海南三亚572000 [2]齐齐哈尔医学院第五附属医院大庆龙南医院神经内科,黑龙江大庆163453

出　　处：《中国现代医学杂志》2014年第31期84-87,共4页China Journal of Modern Medicine

摘　　要：目的探讨不同危险因素在脑梗死和脑出血患者中的分布差异和作用,为脑梗死和脑出血实施针对性的防治提供依据。方法收集2009年3月-2012年9月在该院就诊的脑卒中患者1 732例作为研究对象,将患者分为脑梗死组和脑出血组。采用χ^2检验对两组危险因素分布比较,并将有统计学差异的因素纳入Logistic回归分析,研究不同类型脑卒中的危险因素。结果两组患者男性均占多数,脑梗死患者以75～85岁最多（占41.5%）,脑出血以65～75岁最多（占39.2%）。两组年龄、性别、心脏病家族史分布差异无统计学意义（P〉0.05）。脑梗死组高血压家族史、房颤、糖尿病、吸烟、肥胖、高尿酸、高三酰甘油、高纤维蛋白原、高胆固醇、高LDL-C、低HDL-C、高Apo B、低Apo A所占比例均较脑出血组高（χ^2=28.112、36.038、62.129、8.651、20.887、6.868、5.471、45.666、37.408、28.972、49.844、33.141和11.025,P〈0.05）,该组高血压、饮酒所占比例较脑出血组低（χ^2=72.668和22.643,P〈0.05）。Logistics回归分析显示相对于脑出血,脑梗死危险因素为高血压家族史、房颤、糖尿病、吸烟、肥胖、高LDL-C、低Apo A（OR=2.598、3.653、3.721、1.901、3.528、2.259和1.502,P〈0.05）。而相对于脑梗死,高血压、饮酒为脑出血的危险因素（OR=0.490和0.734,P〈0.05）。结论脑梗死与脑出血危险因素不尽相同,在防治脑卒中过程中,应以不同的危险因素对不同类型脑卒中的影响为依据,采取更有效的治疗措施。[ Objective ] To investigate the difference in the distribution and role of different risk factors in patients with cerebral infarction and cerebral hemorrhage, providing the basis for the implementation of targeted prevention. [Methods] One thousand seven hundred and thirty-two stroke patients from March 2009 to September 2012 in our hospital were collected as research subjects, patients were divided into cerebral infarction group and cerebral hemor- rhage group. X^2 test was used to compare the distribution of risk factors in both groups, and the factors that had sig- nificant differences would be introduced into Logistic regression analysis to study risk factors of different types stroke. [Results] Male patients were the majority in the two groups. Patients of 75 to 85 years were the most in cerebral infarction group （account for 41.5%）, and 65 to 75 years were the most in cerebral hemorrhage （account for 39.2%）. There were no statistical differences in the age, gender, family history of heart disease in the two groups （P〉0.05）. The proportion of family history of hypertension, atrial fibrillation, diabetes, smoking, obesity, high uric acid, high triglycerides, high fibrinogen, high cholesterol, high LDL-C, low HDL-C, high Apo B, Apo A were higher in cerebral infarction than those in cerebral hemorrhage group （X^2=28.112, 36.038, 62.129, 8.651, 20.887, 6.868, 5.471, 45.666, 37.408, 28.972, 49.844, 33.141, 11.025： P 〈0.05）, hypertension, alcohol consumption were lower than cerebral hemorrhage group （X^2=72.668, 22.643： P 〈0.05）. Logistic regression analysis showed that risk factors of cerebral infarction were associated with family history of hypertension, atrial fibrillation, diabetes, smoking, obesity, high LDL-C, low Apo A relative to cerebral hemorrhage （OR=2.598, 3.653, 3.721, 1.901, 3.528, 2.259, 1.502; P 〈 0.05）. Related to cerebral infarction, hypertension, alcohol consumption were the risk factors of cerebral hemorrhage （OR=0.490, 0.734. P 〈0.05）. [Conclusion]

关 键 词：危险因素 脑梗死 脑出血 差异 

分 类 号：R743.3[医药卫生—神经病学与精神病学]