西藏自治区不同年龄藏族脑梗死患者的病因及危险因素分析  

Analysis of etiology and risk factors of cerebral infarction in Zang nationality patients of different ages in Xizang Autonomous Region Renqinglamu

作　　者：仁青拉姆 刘彪 马健峰 张玉飞 赵玉华[2] 熊海 Liu Biao;Ma Jianfeng;Zhang Yufei;Zhao Yuhua;Xiong Hai(Medical College of Xizang Autonomous Region University,Department of Neurology,Xizang Autonomous Region People's Hospital,Lhasa 850000,China;Department of Neurology,Xizang Autonomous Region People's Hospital,Lhasa 850000,China)

机构地区：[1]西藏大学医学院西藏自治区人民医院神经内科,拉萨850000 [2]西藏自治区人民医院神经内科,拉萨850000

出　　处：《中华神经科杂志》2024年第11期1227-1238,共12页Chinese Journal of Neurology

基　　金：西藏地区不同海拔高度藏族人群慢性病及其相关影响因素研究(00061243/002);中央财政支持地方高校改革发展专项基金(00060585);西藏大学研究生高水平人才培养项目(2022-GSP-S122)

摘　　要：目的比较分析西藏自治区不同年龄段藏族脑梗死患者的病因构成及危险因素,为更有针对性地诊治、预防该地区脑梗死提供依据。方法回顾性分析2019年1月至2023年12月在西藏自治区人民医院住院治疗的500例藏族脑梗死患者的临床资料。根据年龄将其分为中青年组(18~59岁)和老年组(60~75岁)。收集各组患者的基线资料、实验室检查数据及影像学检查结果并进行回顾性分析。结果中青年组(n=267)的男性比例[188例(70.41%)]高于老年组(n=233)[130例(55.79%)],差异有统计学意义(χ^(2)=11.485,P=0.001)。中青年组中吸烟[131例(49.06%)比74例(31.76%),χ^(2)=15.401]、饮酒[121例(45.32%)比84例(36.05%),χ^(2)=4.417]、高原红细胞增多症(HAPC)[51例(19.10%)比23例(9.87%),χ^(2)=8.406]、高尿酸血症(HUA)[61例(28.90%)比34例(19.32%)χ^(2)=4.766]、血红蛋白升高[152例(56.93%)比97例(41.63%),χ^(2)=6.677]、高甘油三酯血症[47例(17.60%)比18例(7.73%),χ^(2)=10.734]、高胆固醇血症[12例(4.94%)比3例(1.29%),χ^(2)=4.397]、高脂血症[79例(29.59%)比43例(18.45%),χ^(2)=8.360]比例均高于老年组(均P<0.05)。中青年组高血压[108例(40.44%)比158例(67.81%),χ^(2)=37.413]、心房颤动[5例(1.87%)比20例(8.58%),χ^(2)=11.797]、高同型半胱氨酸血症(HHcy)[159例(59.55%)比168例(72.10%),χ^(2)=8.664]、肌酐异常[18例(6.74%)比29例(12.45%),χ^(2)=4.755]、动脉粥样硬化[113例(42.32%)比145例(62.23%),χ^(2)=19.748]、心脏病[135例(50.56%)比150例(64.38%),χ^(2)=9.690]比例均低于老年组,差异有统计学意义(均P<0.05)。进一步行多因素Logistic回归分析结果显示,高血压病(OR=2.865,95%CI 1.742~4.710)、HHcy(OR=1.968,95%CI 1.177~3.290)是老年组脑梗死的危险因素。吸烟(OR=1.848,95%CI 1.017~3.360)、HAPC(OR=1.993,95%CI 1.991~4.011)、HUA(OR=1.863,95%CI 1.015~3.419)、居住在特高海拔地区(OR=2.405,95%CI 1.207~4.791)是中青年组脑梗死的危险因素。根据TOAST病因分型,其他原因�ObjectiveTo analyze the etiology and risk factors of Zang nationality cerebral infarction patients of different ages in Xizang Autonomous Region,so as to provide basis for more targeted diagnosis,treatment and prevention of cerebral infarction in this region.MethodsThe clinical data of 500 Zang nationality cerebral infarction patients hospitalized in Xizang Autonomous Region People′s Hospital from January 2019 to December 2023 were retrospectively analyzed.According to age,they were divided into young and middle-aged group(18-59 years old)and elderly group(60-75 years old).Baseline data,laboratory data and imaging results of patients in each group were collected and retrospectively analyzed.ResultsThe proportion of males in the young and middle-aged group(n=267)[188(70.41%)]was higher than that in the elderly group(n=233)[130(55.79%),χ^(2)=11.485,P=0.001].The proportion of smokers[131(49.06%)vs 74(31.76%),χ^(2)=15.401],drinkers[121(45.32%)vs 84(36.05%),χ^(2)=4.417],high altitude polycythemia(HAPC)[51(19.10%)vs 23(9.87%),χ^(2)=8.406],hyperuricemia(HUA)[61(28.90%)vs 34(19.32%),χ^(2)=4.766],increased hemoglobin[152(56.93%)vs 97(41.63%),χ^(2)=6.677],hypertriglyceridemia[47(17.60%)vs 18(7.73%),χ^(2)=10.734],hypercholesterolemia[12(4.94%)vs 3(1.29%),χ^(2)=4.397],hyperlipidemia[79(29.59%)vs 43(18.45%),χ^(2)=8.360]in the young and middle-aged group was higher than that in the elderly group(all P<0.05).The proportion of hypertension[108(40.44%)vs 158(67.81%),χ^(2)=37.413],atrial fibrillation[5(1.87%)vs 20(8.58%),χ^(2)=11.797],hyperhomocysteinemia(HHcy)[159(59.55%)vs 168(72.10%),χ^(2)=8.664],abnormal creatinine[18(6.74%)vs 29(12.45%),χ^(2)=4.755],atherosclerosis[113(42.32%)vs 145(62.23%),χ^(2)=19.748],heart disease[135(50.56%)vs 150(64.38%),χ^(2)=9.690]in the young and middle-aged group was lower than that in the elderly group(all P<0.05).Multivariate Logistic regression analysis showed that hypertension(OR=2.865,95%CI 1.742-4.710)and HHcy(OR=1.968,95%CI 1.177-3.290)were risk factors of cerebral infarction

关 键 词：西藏自治区 藏族 脑梗死 危险因素 病因 

分 类 号：R743.33[医药卫生—神经病学与精神病学]