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目的通过对1个大样本的医院脑卒中注册资料的分析,观察各种危险因素在脑卒中患者中的发生率,并对脑梗死与脑出血的危险因素,特别是心脏和动脉病变的因素进行比较。方法研究资料来自瑞士洛桑卒中注册的卒中患者共3901例,其中脑梗死3525例,脑出血376例,均预先对各项临床和辅助资料进行编码,输入计算机数据库。所有病例均进行系统的临床和辅助检查,心脏病变经心电图和超声心动图证实;颈内动脉和椎基底动脉的病变采用彩色超声多普勒、磁共振血管成像或常规脑血管造影确诊。结果高血压在脑出血和脑梗死患者中的发生率分别为53.7%和46.7%,两者相比差异有统计学意义(P<0.01)。高血压是本组脑卒中最突出的危险因素,其后依次是吸烟、轻度颈内动脉狭窄(≤50%)、高胆固醇血症、短暂性脑缺血发作、糖尿病以及心脏缺血。多因素分析研究发现,本组卒中患者无论是男性还是女性,吸烟、高胆固醇血症、短暂性脑缺血发作、心房纤颤、器质性心脏疾病以及动脉病变是脑梗死而非脑出血密切相关的危险因素。易患脑出血的惟一显著相关的危险因素是高血压(OR=0.64,P<0.01);心脏和动脉病变患者更容易发生脑梗死,但是,器质性心脏病和轻度颈内动脉狭窄在全体卒中患者中均特别常见。结论缺血性卒中和出血性卒中的危险因素并不一致,心脏和动脉病变是脑梗死而非脑出血的重要的危险因素,某些危险因素还存在性别差异。
Objective To analyze the incidence of various risk factors in stroke patients by analyzing a large sample of hospital-based stroke registration data and to investigate the risk factors of cerebral infarction and cerebral hemorrhage, especially those of heart and arterial disease Compare Methods Data were collected from 3901 stroke patients registered with stroke in Lausanne, Switzerland. Among them, 3525 were cerebral infarction and 376 were cerebral hemorrhage. All clinical and auxiliary data were encoded in advance and entered into the computer database. All cases were systematically clinical and auxiliary examination, heart disease confirmed by electrocardiogram and echocardiography; internal carotid artery and vertebrobasilar artery lesions using color Doppler ultrasound, magnetic resonance angiography or conventional cerebral angiography confirmed. Results The incidence of hypertension in patients with cerebral hemorrhage and cerebral infarction were 53.7% and 46.7%, respectively, with significant difference (P <0.01). Hypertension was the most prominent risk factor for stroke in this group, followed by smoking, mild carotid stenosis (≤50%), hypercholesterolemia, transient ischemic attack, diabetes and cardiac ischemia. In multivariate analysis, smoking, hypercholesterolemia, transient ischemic attack, atrial fibrillation, structural heart disease, and arterial disease were the most common cause of cerebral infarction but not cerebral hemorrhage in both stroke and stroke patients Related risk factors. The only significant risk factor for developing intracerebral hemorrhage was hypertension (OR = 0.64, P <0.01). Cerebral infarction was more likely in patients with cardiac and arterial disease, but organic and mild internal carotid artery stenosis All stroke patients are particularly common. Conclusions The risk factors for ischemic stroke and hemorrhagic stroke are not consistent. Cardiac and arterial lesions are important risk factors for cerebral infarction but not for intracerebral hemorrhage. There are also gender differences in some risk factors.