Chen Ruiqi, Xiao Anqi, You Chao, Ma Lu
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
World Neurosurg. 2018 Aug;116:e769-e774. doi: 10.1016/j.wneu.2018.05.090. Epub 2018 May 19.
To reveal the characteristics of spontaneous intracerebral hemorrhage (sICH) in a plateau area based on the Tibetan population.
Data of Tibetan and Han patients (control group) with sICH treated at our center from January 2013 to April 2017 were retrospectively reviewed.
A total of 122 Tibetan and 927 Han patients were included. Compared with Han patients, Tibetan patients were older (54.7 ± 11.2 vs. 50.9 ± 18.3 years, P = 0.027), exhibited higher male-to-female ratios (73.8% vs. 55.0%, P < 0.001), were more overweight (22.1% vs. 13.1%, P = 0.007) had more smokers (36.9% vs. 20.5%, P < 0.001), had a higher concentration of hemoglobin (163.7 ± 17.6 vs. 134.8 ± 20.2 g/L, P < 0.001), and included a higher number of patients with hypertension (83.6% vs. 60.5%, P < 0.001), diabetes mellitus (19.2% vs. 9.3%, P = 0.002), and prior hemorrhagic stroke (9.0% vs. 2.0%, P < 0.001). Tibetan patients also experienced more brainstem hemorrhage (11.5% vs. 5.1%, P = 0.039) in the infratentorial region and had a higher risk of in-hospital complications resulting from hematoma enlargement (20.5% vs. 10.4%, P = 0.002) and cerebral infarction (59.0% vs. 9.7%, P < 0.001). During a 6-month follow-up period, they had higher rates of unfavorable outcomes and case mortality (P < 0.05). A multivariable analysis adjusted for confounding factors revealed that the Tibetan race was positively associated with unfavorable clinical outcomes in sICH patients (P < 0.05).
Tibetan sICH patients from the plateau area presented unique characteristics in their baseline measurements, incidence of comorbidities, hematoma location, risk of in-hospital complications, and clinical outcomes compared with Han patients. The Tibetan race was positively associated with unfavorable 6-month outcomes in ICH patients.
基于藏族人群揭示高原地区自发性脑出血（sICH）的特征。
回顾性分析2013年1月至2017年4月在本中心接受治疗的藏族和汉族（对照组）sICH患者的数据。
共纳入122例藏族患者和927例汉族患者。与汉族患者相比，藏族患者年龄更大（54.7±11.2岁 vs. 50.9±18.3岁，P = 0.027），男女比例更高（73.8% vs. 55.0%，P < 0.001），超重者更多（22.1% vs. 13.1%，P = 0.007），吸烟者更多（36.9% vs. 20.5%，P < 0.001），血红蛋白浓度更高（163.7±17.6 vs. 134.8±20.2 g/L，P < 0.001），高血压患者更多（83.6% vs. 60.5%，P < 0.001），糖尿病患者更多（19.2% vs. 9.3%，P = 0.002），既往有出血性卒中史的患者更多（9.0% vs. 2.0%，P < 0.001）。藏族患者幕下区域脑干出血也更多（11.5% vs. 5.1%，P = 0.039），因血肿扩大导致院内并发症的风险更高（20.5% vs. 1（此处疑似有误，应是10.4%）0.4%，P = 0.002），脑梗死风险更高（59.0% vs. 9.7%，P < 0.001）。在6个月的随访期内，他们不良结局和病例死亡率更高（P < 0.05）。对混杂因素进行校正的多变量分析显示，藏族种族与sICH患者不良临床结局呈正相关（P < 0.05）。
与汉族患者相比，来自高原地区的藏族sICH患者在基线测量、合并症发生率、血肿位置、院内并发症风险和临床结局方面呈现出独特特征。藏族种族与ICH患者6个月不良结局呈正相关。
