Zahuranec D B, Brown D L, Lisabeth L D, Gonzales N R, Longwell P J, Eden S V, Smith M A, Garcia N M, Morgenstern L B
Stroke Program, University of Michigan Medical School, Ann Arbor, MI 48109-0316, USA.
Neurology. 2006 Jan 10;66(1):30-4. doi: 10.1212/01.wnl.0000191402.41914.d2.
Mexican Americans (MAs) have higher incidence rates of intracerebral hemorrhage (ICH) than non-Hispanic whites (NHWs). The authors present clinical and imaging characteristics of ICH in MAs and NHWs in a population-based study.
This work is part of the Brain Attack Surveillance in Corpus Christi (BASIC) project. Cases of nontraumatic ICH were identified from 2000 to 2003. Multivariable logistic regression was used to assess the independent associations between ethnicity and ICH location (lobar vs nonlobar) and volume (> or = 30 vs < 30 mL), adjusting for demographics and baseline clinical characteristics. Logistic regression was also used to determine the association between ethnicity and in-hospital mortality, adjusting for confounders.
A total of 149 MAs and 111 NHWs with ICH were identified. MAs were younger (70 vs 77, p < 0.001), more often male (55% vs 42%, p = 0.04), had a lower prevalence of atrial fibrillation (2.0% vs 13%, p < 0.001), and a higher prevalence of diabetes (39% vs 19%, p < 0.001). MA ethnicity was independently associated with nonlobar hemorrhage (OR 2.08, 95% CI: 1.15, 3.70). MAs had over two times the odds of having small (< 30 mL) hemorrhages compared with NHWs (OR = 2.41, 95% CI: 1.31, 4.46). NHWs had higher in-hospital mortality, though this association was no longer significant after adjustment for ICH volume, location, age, and sex.
There are significant differences in the characteristics of ICH in MAs and NHWs, with MA patients more likely to have smaller, nonlobar hemorrhages. These differences may be used to examine the underlying pathophysiology of ICH.
墨西哥裔美国人(MAs)的脑出血(ICH)发病率高于非西班牙裔白人(NHWs)。作者在一项基于人群的研究中呈现了MAs和NHWs中ICH的临床及影像学特征。
这项工作是科珀斯克里斯蒂脑卒中超早期监测(BASIC)项目的一部分。2000年至2003年期间确定了非创伤性ICH病例。使用多变量逻辑回归评估种族与ICH部位(脑叶性与非脑叶性)及出血量(≥30ml与<30ml)之间的独立关联,并对人口统计学和基线临床特征进行校正。还使用逻辑回归确定种族与院内死亡率之间的关联,并对混杂因素进行校正。
共确定了149例患有ICH的MAs和111例患有ICH的NHWs。MAs患者更年轻(70岁对77岁,p<0.001),男性比例更高(55%对42%,p = 0.04),房颤患病率更低(2.0%对13%,p<0.001),糖尿病患病率更高(39%对19%,p<0.001)。MA种族独立与非脑叶性出血相关(比值比2.08,95%置信区间:1.15,3.70)。与NHWs相比,MAs发生小出血量(<30ml)出血的几率是其两倍多(比值比 = 2.41,95%置信区间:1.31,4.46)。NHWs的院内死亡率更高,不过在对ICH出血量、部位、年龄和性别进行校正后,这种关联不再显著。
MAs和NHWs中ICH的特征存在显著差异,MA患者更可能发生较小的非脑叶性出血。这些差异可用于研究ICH的潜在病理生理学。