阿坝藏族羌族自治州缺血性卒中患者发病相关因素分析

摘要

目的：探讨阿坝藏族羌族自治州缺血性卒中患者的危险因素。方法回顾性连续纳入2012年3月至2014年3月四川省阿坝藏族羌族自治州人民医院神经内科缺血性卒中患者314例，所有患者均为藏族。根据是否患有高原性红细胞增多症分为观察组（105例）和对照组（209例），观察组为高原性红细胞增多症合并缺血性卒中患者，对照组为无高原性红细胞增多症的缺血性卒中患者。比较两组卒中发病的常见危险因素，并对差异有统计学意义的单因素指标进行多元Logistic回归分析。结果观察组与对照组高胆固醇血症、嗜烟史、卒中家族史的差异均有统计学意义（χ2值分别为6.489、8.107、11.206，P值分别为0.011、0.004、0.001），其余卒中发病危险因素的组间差异均无统计学意义（均P ＞0.05）。多元Logistic回归分析结果显示，高胆固醇血症、嗜烟史、卒中家族史均为高原性红细胞增多症合并缺血性卒中的独立危险因素（高胆固醇血症：OR ＝4.799，95％ CI：1.266～3.148，P ＝0.028；嗜烟史：OR ＝4.539，95％ CI：1.061～4.182，P ＝0.033；卒中家族史：OR ＝3.549，95％ CI：1.279～5.377，P ＝0.008。结论高胆固醇血症、嗜烟史、卒中家族史为缺血性卒中的危险因素，对该地区缺血性卒中防治应针对地域及人群发病特点。%Objective To investigate the risk factors for ischemic stroke in patients of Aba Tibetan and Qiang Autonomous Prefecture. Methods From March 2012 to March 2014,314 consecutive patients with ischemic stroke admitted to the Department of Neurology,Aba Tibetan and Qiang Autonomous Prefecture People′s Hospital,Sichuan Province were enrolled respectively. All patients were Tibetans. They were divided into either an observation group (n = 105)or a control group (n = 209)according to whether they had high-altitude polycythemia or not. The observation group was the patients with high-altitude polycythemia complicated with ischemic stroke,and the control group was the patients with ischemic stroke without high-altitude polycythemia. The risk factors for onset of stroke in both groups were compared,and the single factor indices with statistical significance were analyzed by multiple logistic regression analysis. Results There were significant differences in hypercholesteremia,history of heavy smoking,and family history of stroke between the observation group and the control group (χ2 values were 6. 489,8. 107,and 11. 206,respectively;P values were 0. 011,0. 004,and 0. 001,respectively). There were no significantly difference in other stroke risk factors between the 2 groups (all P > 0. 05). Multiple logistic regression analysis showed that hypercholesteremia,history of heavy smoking,and family history of stroke were the independent risk factors for high-altitude polycythemia complicated with ischemic stroke (hypercholester-emia:OR,4 . 799 ,95 % CI 1 . 266 - 3 . 148 ,P = 0 . 028;history of heavy smoking:OR,4 . 539 , 95 % CI 1. 061 -4. 182,P =0. 033;family history of stroke:OR,3. 549,95% CI 1. 279 -5. 377,P =0. 008). Conclusions Hypercholesteremia,history of heavy smoking,and family history of stroke,are the independent risk factors for ischemic stroke. The prevention of stroke in the local area should be targeted at the geograph-ical and population characteristics.