拉萨地区脑卒中464例分析  

Analysis of 464 stroke patients in Lhasa

作　　者：张涛[1] 赵玉华[1] 郝渝[1] 米玛顿珠[1] 杨丽辉[1] 次旦卓嘎[1] 

机构地区：[1]西藏自治区人民医院内五科,拉萨850000

出　　处：《中华神经科杂志》2015年第10期861-865,共5页Chinese Journal of Neurology

摘　　要：目的 对拉萨地区脑卒中住院患者进行登记,了解高原地区脑卒中患者的临床特点、危险因素以及预后情况,为高原地区脑卒中的临床防治提供参考.方法 建立基于医院的脑卒中登记库,对脑卒中患者进行登记随访,采集患者的一般社会学特征、临床特征、诊治情况等内容进行分析.结果 连续登记2007年7月1日至2013年3月30日收住西藏自治区人民医院的464例脑卒中患者,其中藏族患者332例,汉族患者132例,平均年龄（57.45±16.14）岁,男性326例,女性138例.发病年龄小于40岁的患者68例（14.22％）.脑卒中亚型以脑梗死最多[322例（69.40％）],其次为脑出血[129例（27.80％）]、蛛网膜下腔出血[13例（2.80％）].藏族患者中男女性别构成比（213：119）与汉族患者（113：19）差异存在统计学意义（χ^2 =20.795,P＜0.001）.脑卒中患者4.5h内就诊率为18.53％（86/464）,脑梗死患者4.5h内就诊率为13.35％（43/322）,其中1例患者行静脉溶栓治疗,占全部脑梗死患者的0.31％（1/322）.分析本组脑卒中患者的主要危险因素分别为：高血压[249例（53.66％）]、心脏病[102例（21.98％）]、糖尿病[67例（14.43％）]和慢性高原红细胞增多症[65例（14.00％）].结论 高原地区脑卒中患者有年轻化的趋势,4.5h内就诊率偏低,脑梗死患者行静脉溶栓比例较低.慢性高原红细胞增多症成为高原地区特有的危险因素.Objective To register the inpatients with stroke in Lasa plateau region,understand the clinical characteristics,risk factors and prognosis of patients with stroke in plateau region,and provide reference for prevention and treatment of stroke in plateau region.Methods Hospital-based stroke registration database was established,follow-up visits were paid to registered patients with stroke;the general sociological characteristics,clinical features,diagnosis and treatment situations of patients were collected and analyzed.Results Continuous registration in 464 patients with stroke in Tibet Autonomous Region People′ s Hospital was made from July 1,2007 to March 30,2013,including 332 Tibetan patients and 132 Han patients,whose average age was （57.45 ± 16.14） years;326 male patients,138 female patients.Sixty-eight patients′ age of onset was smaller than 40 years （14.22%）.Among stroke subtypes,cerebral infarction was the most frequent syndrome （322 patients （69.40%））,followed by brain hemorrhage （129 patients （27.80%））,subarachnoid hemorrhage （13 patients （2.80%））.The difference between the male to female ratio of Tibetan patients （213：119） and Han patients（113：19） was statistically significant （χ^2 =20.795,P 〈0.001）.The 4.5 h clinic visit rate of patients with stroke was 18.53% （86/464）,the 4.5 h clinic visit rate of patients with cerebral infarction was 13.35% （43/322）,including 1 patient who took intravenous thrombolytic therapy,accounting for 0.31% of patients with cerebral infarction.The analysis indicated that the major risk factors of this group of patients with stroke were high blood pressure （249 patients （53.66%））,heart disease （102 patients （21.98%））,diabetes （67 patients （14.43%）） and chronic high altitude polycythemia （65 patients （14.00%））.Conclusions The patients with stroke in plateau regions tend to be younger,the clinic visit rate within 4.5 h is low,and the application of intravenous thrombolysis in patients

关 键 词：卒中 红细胞增多症 高海拔 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]