广西两所三级医疗机构脑卒中住院病例亚型构成及流行特征分析  

Analysis of subtypes and epidemic characteristics of stroke in two tertiary hospitals of Guangxi

作　　者：陆伟江[1] 杨虹[1] 黄颖[1] 岑鸿蕾 孟军[1] 罗水英[1] 许晶晶[1] 蔡剑锋[1] 

机构地区：[1]广西壮族自治区疾病预防控制中心慢性病防制所,广西南宁530028

出　　处：《中国慢性病预防与控制》2016年第6期405-408,共4页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：广西壮族自治区卫生计划生育委员会项目(Z2014156)

摘　　要：目的了解广西居民近10年间脑卒中的流行特征及亚型特点,为广西脑卒中预防与控制策略的制订及调整提供数据支持。方法按照全国第四次脑血管病学术会议中各类脑血管疾病诊断要点,选取广西2所三级医疗机构2003年、2008年和2013年病案首页信息完整,并确诊为脑卒中患者的住院病例资料,分析3个年度中的脑卒中亚型构成情况及流行特征,用SPSS 17.0软件对数据进行t检验和χ2检验分析。结果共收集脑卒中住院病例6 752例,其中2003年、2008年和2013年的病例数分别占12.2%、36.4%、51.4%。男性4 560例（67.5%）,首发病例5 079例（75.2%）。在脑卒中亚型构成中,脑梗死比例最高,为79.3%,其他依次为脑出血（14.6%）,蛛网膜下腔出血（4.9%）和其他类型脑卒中（1.2%）;且无论男性或女性,脑卒中各亚型在男女性别间差异均无统计学意义（χ2值分别为0.87、0.66、0.001和1.81,P＆gt;0.05）,而在不同年龄组中蛛网膜下腔出血、脑出血和脑梗死3个亚型构成差异均有统计学意义（χ2值分别为298.40、327.66、597.30,P〈0.01）。蛛网膜下腔出血、脑出血均以〈35岁组比例最高,分别为23.0%和44.6%,脑梗死在55~、65~和≥75岁组比例较高,分别为80.2%、86.4%和89.2%。脑卒中患者常见的慢性病并发症主要有原发性高血压、2型糖尿病（T2DM）等,其中合并高血压为63.4%,合并T2DM为18.0%。脑梗死合并高血压为65.9%,脑出血合并高血压为63.4%,脑梗死合并T2DM为20.5%,脑梗死合并T2DM的比例明显高于蛛网膜下腔出血和脑出血合并T2DM的比例,差异均有统计学意义（P〈0.01）。结论近10年广西脑卒中住院病例数明显增多,且呈现出年轻化趋势。男性及55岁以上的中老年人是预防脑卒中的重点人群,应加强对重点人群的健康干预,控制血压、维持血糖稳定是当前对脑卒中防控的重要环节。Objective To understand the epidemiological characteristics and subtypes of stroke in Guangxi during last 10 years,and to provide data for the prevention and control strategy of stroke in Guangxi. Methods The data of hospitalized patients with stroke of two Guangxi tertiary hospitals in 2003, 2008 and 2013 were analyzed for subtypes and epidemic characteristics of stroke.χ2test and t test were used to analyzed statistically the data with SPSS 17.0 software. Results Total of 6 752 cases（4 560 males,67.5%; 5 079 cases with the first onset, 75.2%） of hospitalized patients with stroke served as the subjects, the proportions of cases in 2003, 2008 and 2013 were 12.2%, 36.4% and 51.4%, respectively. The proportions of cerebral infarction, cerebral hemorrhage,subarachnoid hemorrhage and other cerebral stroke were 79.3%, 14.6%, 4.9% and 1.2%, respectively. There was no significant difference of stroke subtypes between males and females（ P 〉0. 05）. But there were significant differences of stroke subtype distributions among different age groups（P〈0.01）. The proportions of cerebral hemorrhage and subarachnoid hemorrhage in 35years old group was the highest（23.0% and 44.6%）, the proportions of cerebral infarction in 55-, 65-and ≥75 years old groups were higher（80.2%,86.4% and 89.2%, respectively）. The main chronic complications in stroke cases were primary hypertension（ 63.4%） and type 2 diabetic mellitus（ T2 DM, 18.0%）. The proportions of cerebral infarction with hypertension, cerebral hemorrhage with hypertension and cerebral infarction with T2 DM were 65.9%, 63.4% and 20.5%, respectively. As compared with cerebral hemorrhage and subarachnoid hemorrhage, the proportions of cerebral infarction with hypertension or T2 DM significantly increased（P〈0.01）. Conclusion Last 10 years, the hospitalized patients with stroke in Guangxi significantly increased with young trend. Male and 55 years old residents are the residents with high risk of stroke, the health intervention measures should

关 键 词：脑梗死 脑出血 合并症 流行特征 

分 类 号：R743.3[医药卫生—神经病学与精神病学]