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目的 :观察不同性别急性脑血管病临床特点的差异 ,探讨内源性雌激素水平变化在女性脑血管病发病中可能的作用。方法 :收集十堰地区主要三级医院自 1997年初～ 2 0 0 0年 6月连续收治的 12 93例急性脑梗死(80 0例 )及脑出血 (493例 )患者资料 ,根据年龄划分为 (<4 5 ,4 5～ 5 4 ,5 5～ 6 4 ,≥ 6 5岁 )四组 ,对患病例数、既往史、病变部位、并发症、病死率等临床特点 ,进行男女对比分析。结果 :女性脑血管病总发病率低于男性 ,女性绝经后期脑梗死发病率是围绝经期的 2 .4倍 ,但同年龄组男、女性脑梗死及脑出血患者例数比例、病变部位、病死率均无统计学差异。既往史中 ,脑梗死女性患者患高血压病 (6 7.9% )及心脏病 (15 .3% )等基础疾病的比例高于男性 (5 6 .1%和 8.3% ) ,P <0 .0 5。女性脑卒中应激性溃疡和肺部感染发生率均低于男性 (脑梗死为 2 .4 %和 5 .6 %比 7.0 %和 12 .2 % ,脑出血为 9.4 %和 11.9%比 17.9%和 2 6 .5 % ) ,P <0 .0 5。结论 :急性脑血管病患者性别间在总发病率、既往史及并发症等方面有一定差异 ,内源性雌激素水平对女性脑卒中临床特点可能有一定影响。
Objective: To observe the difference of clinical features of acute cerebral vascular disease of different sexes and to explore the possible role of the change of endogenous estrogen level in the pathogenesis of cerebrovascular disease in women. Methods: A total of 1293 cases of acute cerebral infarction (80 0 cases) and cerebral hemorrhage (493 cases) admitted to the main tertiary hospitals in Shiyan district from early 1997 to June 2000 were collected and classified according to age (< 4 5, 4 5 ~ 5 4, 5 5 ~ 6 4, ≥ 65 years old) were divided into four groups. The clinical characteristics of the patients, the past history, the lesion site, complications and mortality were analyzed. Results: The overall incidence of cerebrovascular disease in females was lower than that in males. The incidence of post-menopausal cerebral infarction in females was 2.4 times that of menopausal women. However, the proportions of patients with cerebral infarction and cerebral hemorrhage in the same age group, No significant difference in case fatality rate. In the past history, the prevalence of essential diseases such as hypertension (6.89%) and heart disease (15.3%) were higher in female patients with cerebral infarction than in men (56.1% vs 8.3%), P <0. 0 5. The incidence of stress ulcer and pulmonary infection was lower in women than in men (cerebral infarction was 2.4% vs 5.6% vs 7.0% vs 12.2%, cerebral hemorrhage 9.4% vs 11.9% vs 17.9% And 26.5%), P <0.05. Conclusion: There is a certain difference in the overall incidence, past history and complications between patients with acute cerebrovascular disease. The level of endogenous estrogen may have some impact on the clinical characteristics of women with stroke.