Department of Emergency Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China (Zhang J, Wang Y, Wang GN, Sun H, Zhang JS); Department of Epidemiology and Biostatistics, Nanjing Medical University, Nanjing 210029 China (Sun T); Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China (Shi JQ); Laboratory of Neurotoxicology, School of Public Health, Nanjing Medical University, Nanjing 210029, China (Xiao H).
World J Emerg Med. 2011;2(1):18-23. doi: 10.5847/wjem.j.1920-8642.2011.01.003.
Stroke is one of the leading causes of mortality and morbidity of vascular diseases, and its incidence maintains at a high level around the world. In China, stroke has been a major public health problem. Because the pathogenesis of ischemic stroke is different from that of hemorrhagic stroke, their clinical factors would not be the same. Therefore to investigate the different effects of various effect factors on ischemic versus hemorrhagic stroke and then to enhance the prevention are crucial to decrease the incidence.
A total of 692 patients, consisting of 540 ischemic stroke patients and 152 hemorrhagic stroke patients from East China, were included in this study. The related factors of stroke subtypes were collected and analyzed.
The factors significantly associated with ischemic stroke as opposed to hemorrhagic stroke were family history of stroke, obesity, atherosclerotic plaque of the common carotid artery, atrial fibrillation, hyperfibrinogenemia, transient ischemic attack (TIA), atherosclerotic plaque of the internal carotid artery, coronary heart, lower high-density lipoproteins (lower HDL), increasing age, diabetes mellitus, and gender (male) (P<0.05). Leukocytosis, hypertension and family history of hypertension were the significant factors associated with hemorrhagic stroke versus ischemic stroke. Smoking, drinking, kidney diseases and lower HDL-C were the significant factors contributing to ischemic stroke in man. Obesity, family history of hypertension, family history of stroke, hypercholesteremia and myocardial ischemia were the significant factors for females with ischemic stroke.
The most prominent factors for overall stroke in East China were hypertension, followed by higher pulse pressure and hypercholesteremia. The factors for ischemic and hemorrhagic stroke are not the same. Different effects of risk factors on stroke are found in male and female patients.
中风是血管疾病导致的死亡和发病的主要原因之一，其发病率在全球范围内保持在较高水平。在中国，中风一直是一个主要的公共卫生问题。由于缺血性中风的发病机制与出血性中风不同，其临床因素也不会相同。因此，研究各种影响因素对缺血性和出血性中风的不同影响，进而加强预防，对于降低发病率至关重要。
本研究共纳入华东地区 692 例患者，其中缺血性中风患者 540 例，出血性中风患者 152 例。收集并分析了中风亚型的相关因素。
与出血性中风相比，与缺血性中风显著相关的因素有中风家族史、肥胖、颈总动脉粥样硬化斑块、心房颤动、高纤维蛋白原血症、短暂性脑缺血发作（TIA）、颈内动脉粥样硬化斑块、冠心病、低高密度脂蛋白（HDL）、年龄增长、糖尿病和性别（男性）（P<0.05）。白细胞增多、高血压和高血压家族史是与出血性中风显著相关的因素。吸烟、饮酒、肾脏疾病和低 HDL-C 是男性缺血性中风的显著危险因素。肥胖、高血压家族史、中风家族史、高胆固醇血症和心肌缺血是女性缺血性中风的显著危险因素。
华东地区总体中风的最主要危险因素是高血压，其次是较高的脉压和高胆固醇血症。缺血性和出血性中风的危险因素并不相同。在男性和女性患者中，风险因素对中风的影响也不同。
