Tsai Chung-Fen, Jeng Jiann-Shing, Anderson Niall, Sudlow Cathie L M
Department of Neurology, Cardinal Tien Hospital, Fu Jen Catholic University, Taipei, Taiwan.
Neuroepidemiology. 2017;48(1-2):72-78. doi: 10.1159/000475667. Epub 2017 May 13.
Chinese populations have a higher stroke incidence, a higher proportion of intracerebral hemorrhage (ICH), and a lower proportion of ischemic stroke (IS) as compared with white populations. The reasons are not fully understood.
To evaluate the differences of major risk factors between ICH and IS in Chinese stroke patients, we analysed acute ICH and IS patients consecutively recruited in National Taiwan University Hospital Stroke Registry from 2006 to 2011. We used multiple logistic regression models to examine the associations of risk factors with ICH vs. IS. Also, we conducted subgroup analyses when a strongly significant interaction was detected.
We included a total of 1,373 ICH and 4,953 IS patients. ICH patients were younger than IS patients (mean age 61 vs. 68 years, p < 0.001), but there was no significant difference in gender (males 62 vs. 59%, p = 0.064). A logistic regression model adjusted for age, gender, and other major risk factors showed that both hypertension (OR 2.23, 95% CI 1.74-2.87) and alcohol intake (OR 1.44, 95% CI 1.16-1.77) had significantly stronger associations with ICH than IS, whereas diabetes, atrial fibrillation, ischemic heart disease, hyperlipidemia, smoking, and transient ischemic attack were less associated with ICH than IS. In subgroup analyses, the association of hypertension with ICH vs. IS was more marked in younger patients.
Hypertension and alcohol intake are more strongly associated with ICH than IS in Chinese stroke patients, especially in younger patients.
与白人相比，中国人群的中风发病率更高，脑出血（ICH）比例更高，缺血性中风（IS）比例更低。原因尚不完全清楚。
为评估中国中风患者中ICH和IS主要危险因素的差异，我们分析了2006年至2011年连续纳入台湾大学医院中风登记处的急性ICH和IS患者。我们使用多元逻辑回归模型来检验危险因素与ICH和IS的关联。此外，当检测到强显著交互作用时，我们进行了亚组分析。
我们共纳入了1373例ICH患者和4953例IS患者。ICH患者比IS患者年轻（平均年龄61岁对68岁，p<0.001），但性别无显著差异（男性分别为62%和59%，p=0.064）。调整年龄、性别和其他主要危险因素的逻辑回归模型显示，高血压（比值比2.23，95%置信区间1.74-2.87）和饮酒（比值比1.44，95%置信区间1.16-1.77）与ICH的关联显著强于IS，而糖尿病、心房颤动、缺血性心脏病、高脂血症、吸烟和短暂性脑缺血发作与ICH的关联弱于IS。在亚组分析中，高血压与ICH和IS的关联在年轻患者中更为明显。
在中国中风患者中，尤其是年轻患者，高血压和饮酒与ICH的关联比与IS的关联更强。
