出血性卒中和缺血性卒中相关影响因素的病例对照研究

目的探索广西出血性卒中和缺血性卒中相关影响因素,为提出有针对性的脑卒中健康干预措施提供依据。方法采用1∶1频数匹配病例对照研究方法,2016年10月-2017年10月在广西5个县(区)的县级医院收集新发出血性卒中和缺血性卒中病例,按照与病例性别、年龄(±4岁)、民族等进行1∶1频数匹配,从普通人群中收集对照组研究对象。采用面对面问卷调查,收集病例和对照组的一般情况、身体健康状况、体重变化情况、行为生活方式并进行体格检测。先采用SPSS 22.0统计软件包的t检验、χ^2检验进行单因素分析,再采用logistic回归进行多因素分析。结果共调查418对病例及对照,其中,男性、女性分别为270对和148对,出血性卒中132人,缺血性卒中286人。研究结果显示,现患高血压、脑卒中家族史、一年四季都午睡和口味偏咸均是出血性脑卒中、缺血性脑卒中和脑卒中的危险因素;现患糖尿病、口味偏咸和油腻是缺血性脑卒中和脑卒中的危险因素;打鼾、患病前体重变为低体重是出血性脑卒中的危险因素;在外就餐≥6次/周是缺血性卒中的危险因素。夏季午睡是出血性卒中的保护因素(OR=0.5,95%CI:0.2-0.9),居住农村是缺血性卒中的保护因素(OR=0.5,95%CI:0.3-0.7),居住农村、患病前体重变正常是脑卒中的保护因素。结论广西地区出血性卒中和缺血性卒中相关影响因素存在一定差异,并可能存在特异影响因素,需根据脑卒中的类型有针对性开展相关健康干预。

A case-control study on the related factors of hemorrhagic stroke and ischemic stroke

Objective To explore the related factors of hemorrhagic stroke and ischemic stroke in Guangxi,and provide scientific evidence for health interventions on stroke.Methods A 1:1 frequency matched case-control study design was used.The new diagnosis cases of hemorrhagic stroke and ischemic stroke in county hospitals from five counties or districts in Guangxi between October 2016 to October 2017 were collected and the control subjects matching with the cases on gender,age(±4 years),ethnicity were collected from the general population.Face-to-face questionnaire was used to collect the general information,physical health status,the change of body weight,behavior and lifestyle,and physical examination was performed.SPSS 22.0 statistical software package was used for t test and chi-square test to perform univariate analysis,and logistic regression was used to perform multivariate analysis.Results A total of 418 cases and controls were investigated.Among them,270 were male and 148 were female,132 were hemorrhagic stroke,and 286 were ischemic stroke.The analysis re sults showed that hypertension,family history of stroke,napping throughout the year,and salty taste were risk factors for hemorrhagic stroke,ischemic stroke,and stroke.Diabetes,salty taste and gre asy were risk factors for ischemic stroke and stroke.Snoring and low body weight before illness were risk factors for hemorrhagic stroke.Dining out more than 6 times/week was a risk factor for ischemic stroke.Summer siesta was a protective factor for hemorrhagic stroke(OR=0.5,95% CI:0.2-0.9).Living in rural area was a protective factor for ischemic stroke(OR=0.5,95% CI:0.3-0.7).Living in rural areas and normal body weight before illness were a protective factors for stroke.Conclusion There were some differences between the related influencing factors of hemorrhagic stroke and ischemic stroke in Guangxi,and specific influencing factors may exist.Health intervention should be carried out according to the different types of stroke.