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目的了解广西居民近10年间脑卒中的流行特征及亚型特点,为广西脑卒中预防与控制策略的制订及调整提供数据支持。方法按照全国第四次脑血管病学术会议中各类脑血管疾病诊断要点,选取广西2所三级医疗机构2003年、2008年和2013年病案首页信息完整,并确诊为脑卒中患者的住院病例资料,分析3个年度中的脑卒中亚型构成情况及流行特征,用SPSS 17.0软件对数据进行t检验和χ2检验分析。结果共收集脑卒中住院病例6 752例,其中2003年、2008年和2013年的病例数分别占12.2%、36.4%、51.4%。男性4 560例(67.5%),首发病例5 079例(75.2%)。在脑卒中亚型构成中,脑梗死比例最高,为79.3%,其他依次为脑出血(14.6%),蛛网膜下腔出血(4.9%)和其他类型脑卒中(1.2%);且无论男性或女性,脑卒中各亚型在男女性别间差异均无统计学意义(χ2值分别为0.87、0.66、0.001和1.81,P>0.05),而在不同年龄组中蛛网膜下腔出血、脑出血和脑梗死3个亚型构成差异均有统计学意义(χ2值分别为298.40、327.66、597.30,P<0.01)。蛛网膜下腔出血、脑出血均以<35岁组比例最高,分别为23.0%和44.6%,脑梗死在55~、65~和≥75岁组比例较高,分别为80.2%、86.4%和89.2%。脑卒中患者常见的慢性病并发症主要有原发性高血压、2型糖尿病(T2DM)等,其中合并高血压为63.4%,合并T2DM为18.0%。脑梗死合并高血压为65.9%,脑出血合并高血压为63.4%,脑梗死合并T2DM为20.5%,脑梗死合并T2DM的比例明显高于蛛网膜下腔出血和脑出血合并T2DM的比例,差异均有统计学意义(P<0.01)。结论近10年广西脑卒中住院病例数明显增多,且呈现出年轻化趋势。男性及55岁以上的中老年人是预防脑卒中的重点人群,应加强对重点人群的健康干预,控制血压、维持血糖稳定是当前对脑卒中防控的重要环节。
Objective To understand the epidemiological characteristics and subtypes of stroke in recent 10 years in Guangxi residents and provide data support for the formulation and adjustment of stroke prevention and control strategies in Guangxi. Methods According to the diagnostic points of various types of cerebrovascular diseases in the Fourth Conference on Cerebrovascular Diseases in China, two inpatient cases of two third-grade medical institutions in Guangxi in 2003, 2008 and 2013 were selected as complete information and were diagnosed as stroke patients Data, analysis of the three sub-types of stroke in the composition and prevalence characteristics of the data using SPSS 17.0 t test and χ2 test analysis. Results A total of 6 752 hospitalized stroke patients were collected, of which 12.2%, 36.4% and 51.4% respectively in 2003, 2008 and 2013. 4,605 were male (67.5%), and 5,079 (75.2%) were initial. Among the stroke subtypes, the highest proportion of cerebral infarction was 79.3%, followed by cerebral hemorrhage (14.6%), subarachnoid hemorrhage (4.9%) and other types of stroke (1.2%); and whether male or There was no significant difference between female and stroke genotypes in male and female (χ2 = 0.87,0.66,0.001 and 1.81, P> 0.05), but in different age groups, subarachnoid hemorrhage, intracerebral hemorrhage and There were significant differences in the three subtypes of cerebral infarction (χ2 = 298.40,327.66,597.30, P <0.01). The rates of subarachnoid hemorrhage and intracerebral hemorrhage were the highest in 35-year-old group, accounting for 23.0% and 44.6% respectively. The incidence of cerebral infarction was higher in 55-65- and ≥75-year-old group with 80.2% and 86.4% 89.2%. Complications of stroke in patients with common chronic diseases are mainly hypertension, type 2 diabetes (T2DM), etc., of which 63.4% with hypertension, combined with T2DM was 18.0%. Cerebral infarction with hypertension was 65.9%, cerebral hemorrhage with hypertension was 63.4%, cerebral infarction with T2DM was 20.5%, the proportion of cerebral infarction with T2DM was significantly higher than that of subarachnoid hemorrhage and cerebral hemorrhage with T2DM, the difference was There was statistical significance (P <0.01). Conclusions The number of hospitalized cases of stroke in Guangxi increased significantly in the recent 10 years and showed a trend of younger age. Men and the middle-aged and the elderly over 55 years old are the key people in the prevention of stroke. Health interventions should be strengthened for key populations. Controlling blood pressure and maintaining stable blood glucose level are the important links in the prevention and control of stroke.