新疆高血压住院患者脑血管病相关危险因素分析

摘要

Objective To explore the prevalence of cerebrovascular diseases combined with hypertension and its related risk factors in the inpatients who attended the Hypertension Unit of provincial general hospital. Methods The prevalence of cerebrovascular diseases combined with hypertension and its related risk fac-tors were analyzed in 4642 hypertensive patients who attended the Hypertension Unit of provincial general hospital from 1997 to 2005 in the present retrospective study,all the patients were clearly diagnosed as es-sential hypertension.The 4642 cases were divided into groups of non stroke,brain stroke,ischemic cere-bral stroke,mixed stroke hemorrhage group.Gender,nationality,age,primary hypertension,type 2 dia-betes,sleep apnea and pause syndrome,lipid metabolism disorders,high homocysteine and other risk fac-tors were analyzed by chi square test and logistic regression respectively.Results The discovery rate of stroke was 13.6% in the total 4642 inpatients who attended the Hypertension Unit.The discovery rate of stroke was higher in males than that in females;Han population had the highest discovery rate of stroke, the next was Uygur and Hui population,though no statistical difference was found among these ethnic groups.The occurrence probability of cerebral hemorrhage in male inpatients was 3.312-fold more than that of female inpatients;The occurrence probability of ischemia stroke was 1.441-fold increased in the hy-pertensive patients than those with normal blood pressure.Considered the patients elder than 66-year-old as the parametic group,the probability of ischemia stroke was 0.048-fold in 22 to 32-year-old group than those in parametic group,0.134-fold in 33 to 43-year-old group,0.343-fold in 44 to 54-year-old group and 0.776-fold in 55 to 65-year-old group;the mixed stroke occurrence rate in patients with essential hyperten-sion or diabetes was 3.223-fold higher than the normotensive individuals and 2.045-fold higher than the pa-tients without diabetes.Similarly,the rate of the mixed stroke was lower compared with that in elder than 66-year-old group,which were 0.146-fold in and 33 to 43-year-old group and 0.357-fold in and 44 to 54-year-old group,separately.Conclusion These results suggest that age,gender,essential hypertension, hyperhomocysteinemia and diabetes contribute to the occurrence of stroke mainly in the hypertensive pa-tients of Xinjiang.%目的：评估高血压住院患者脑血管病的发生状况及其相关危险因素。方法将1997—2005年在新疆维吾尔自治区人民医院高血压中心住院并诊断明确的4642例高血压患者分为无脑卒中组、出血性脑卒中组、缺血性脑卒中组、混合性脑卒中组，对性别、民族、年龄、原发性高血压、2型糖尿病、睡眠呼吸暂停综合征、脂代谢紊乱、高同型半胱氨酸血症等危险因素分别进行卡方检验及 Logistic 回归分析。结果在4642例高血压住院患者中脑卒中检出率为13．6％。在不同性别之间，男性脑卒中检出率显著高于女性，男性患脑出血的概率是女性的3．312倍。在不同民族之间，汉族脑卒中检出率最高，其次是维吾尔族和回族，但差异无统计学意义。以年龄＞65岁的患者为对照，不同年龄组发生缺血性脑卒中的概率分别是对照组的0．048倍（22～32岁）、0．134倍（33～43岁）、0．343倍（44～54岁）、0．776倍（55～65岁），差异具有统计学意义；33～43岁发生混合性脑卒中的概率是对照组的0．146倍，44～54岁发生混合性脑卒中的概率是对照组的0．357倍，具有统计学差异。原发性高血压患缺血性卒中的概率是非原发性高血压的1．441倍，具有统计学差异。原发性高血压、2型糖尿病患混合性卒中的概率是非原发性高血压、非2型糖尿病的3．223、2．045倍，差异有统计学意义。结论影响新疆高血压人群脑卒中的主要危险因素是年龄、性别、高血压病、高同型半胱氨酸血症、2型糖尿病。