Li Wenwen, Sun Qiying, Duan Xian, Yi Fang, Zhou Yafang, Hu Yacen, Yao Lingyan, Xu Hongwei, Zhou Lin
Department of Geriatrics Neurology, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2018 Nov 28;43(11):1246-1250. doi: 10.11817/j.issn.1672-7347.2018.11.013.
To determine the etiologies and risk factors of intracerebral hemorrhage in young people. Methods: A total of 401 young patients with intracerebral hemorrhage were enrolled, and they were assigned into a 20-29 , a 30-39, and a 40-45 age group. The differences of various etiologies and risk factors among the three groups were analyzed. Results: There were 273 men and 128 women in the 401 young patients. The etiologies of 294 patients (73.32%) were identified while 107 patients (26.68%) were unknown. Among those with identified etiology, 226 patients (56.36%) suffered from hypertension, 41 patients (10.22%) congenital cerebrovascular malformation (including 25 patients with cerebral arteriovenous malformation, 8 intracranial cavernous hemangioma, and 8 intracranial aneurysm), and 27 other etiologies (including 9 patients with moyamoya disease, 6 cerebral venous sinus thrombosis, 4 drug abuse, 3 hemorrhagic brain tumor, 2 intracranial infection, 1 systemic lupus erythematosus, 1 drug-induced, and 1 eclampsia). Risk factors included hypertension (237 cases, 59.10%), smoking (123 cases, 30.67%), alcohol consumption (74 cases, 18.45%), and others (19 cases, 4.74%; including 8 cases of pregnancy or in the puerperium, 8 family history of intracerebral hemorrhage, and 3 taking anti-platelet aggregation/anticoagulation agents). The rate of hypertension induced hemorrhage significantly increased with age (P<0.01); the rate of vascular malformations in 20-29 age group was obviously higher than other groups (P<0.01); the rate of unknown cause in the 40-45 age group was significantly lower than other groups (P<0.01) and the rate of other etiologies showed no significant difference in the 3 groups. The rate of hypertension was significantly elevated with the age (P<0.01), while smoking, alcohol consumption, and other risk factors showed no significant difference in the 3 groups. Conclusion: The rate of intracerebral hemorrhage in young people increases with the increasing of age and hemorrhage affects men more than women; hypertension may be the main cause and congenital cerebrovascular malformation is the second cause, which may be more common in younger patients. Hypertension, smoking, and alcohol consumption may be the major controllable risk factors in intracerebral hemorrhage in young people.
确定年轻人脑出血的病因及危险因素。
共纳入401例年轻脑出血患者，分为20 - 29岁、30 - 39岁和40 - 45岁年龄组，分析三组间各种病因及危险因素的差异。
401例年轻患者中，男性273例，女性128例。294例（73.32%）患者病因明确，107例（26.68%）病因不明。病因明确的患者中，226例（56.36%）患有高血压，41例（10.22%）为先天性脑血管畸形（包括25例脑动静脉畸形、8例颅内海绵状血管瘤和8例颅内动脉瘤），27例为其他病因（包括9例烟雾病、6例脑静脉窦血栓形成、4例药物滥用、3例出血性脑肿瘤、2例颅内感染、1例系统性红斑狼疮患者、1例药物所致及1例子痫）。危险因素包括高血压（237例，59.10%）、吸烟（123例，30.67%）、饮酒（74例，18.45%）及其他（19例，4.74%；包括8例妊娠或产褥期、8例脑出血家族史及3例服用抗血小板聚集/抗凝剂）。高血压所致出血率随年龄显著增加（P<0.01）；20 - 29岁年龄组血管畸形发生率明显高于其他组（P<0.01）；40 - 45岁年龄组病因不明率显著低于其他组（P<0.01），其他病因在三组间差异无统计学意义。高血压发生率随年龄显著升高（P<0.01），而吸烟、饮酒及其他危险因素在三组间差异无统计学意义。
年轻人脑出血发生率随年龄增加而升高，男性受出血影响多于女性；高血压可能是主要病因，先天性脑血管畸形是次要病因，在年轻患者中可能更常见。高血压、吸烟和饮酒可能是年轻人脑出血的主要可控危险因素。
