青年和中老年患者脑出血危险因素及预后的相关性探讨

目的探讨青年和中老年患者脑出血的危险因素及预后。方法选取我院2013-06—2014-06自发性脑出血患者362例,根据年龄不同分为青年组(≤45岁)142例与中老年组(45岁)220例。探讨2组患者脑出血的危险因素。并于治疗结束后1a进行电话随访,随访内容主要包括死亡情况、有无残疾、有无复发脑出血及预后情况。结果高血压是发生脑出血的最主要原因及危险因素,中老年组脑出血患者高血压发生率明显高于青年组,差异有统计学意义(P0.05)。青年组患者脑出血危险因素主要是高血压与脑部动静脉畸形,中老年组患者脑出血危险因素主要是高血压、糖尿病、高血脂、高NIHSS评分,差异有统计学意义(P0.05)。脑出血好发部位为基底核区,其次是丘脑。中老年组预后情况较差,病死率、残疾率较高,差异有统计学意义(P0.05)。脑出血复发率2组无明显差异(P0.05)。结论高血压是各个年龄阶段造成脑出血的独立危险因素。糖尿病、高血脂与高NIHSS评分是中老年组患者脑出血的危险因素。预后主要与年龄有关,年龄45岁是导致预后差的主要因素之一。

Related discussion of the risk factors and prognosis in young and middle-aged patients with cerebral hemor-rhage

Objective To explore the risk factors and prognosis in young and middle-aged patients with cerebral hemor‐rhage .Methods Clinical data from 362 patients with spontaneous cerebral hemorrhage who met inclusion criteria in our hospi‐tal from June 2013 to June 2014 were collected to conduct this retrospective analysis .There were 142 cases in young group(≤45 years old) and 220 cases in middle-aged group(>45 years old) according to age .We explored the risk factors and compared the prognosis of the two groups by collecting prognostic items containing death ,disability and cerebral re-bleeding after tele‐phone follow-up for one year .Results Hypertension was the main cause and risk factor of cerebral hemorrhage .The incidence of hypertension in the middle-aged group was significantly higher than that in the young group(P<0.05) .Additionally ,the main risk factors were hypertension and cerebral arteriovenous malformation in young group and were hypertension ,diabetes , hyperlipidemia and high NIHSS scores in middle-aged group ,all differences were significant(P<0.05) .Cerebral hemorrhage was most common in basal ganglia region ,followed by thalamus .Patients in middle-aged group had worse prognosis ,for the mortality and disability rate were higher which showed statistical differences (P<0.05) .There was no significant difference in recurrence rate of cerebral hemorrhage between two groups (P>0.05) .Conclusion Hypertension is an independent cause of cerebral hemorrhage .Diabetes ,hyperlipidemia and high NIHSS scores may be regarded as risk factors in middle-aged patients with cerebral hemorrhage .Prognosis has close relation with age and over 45 years old may be the one of main causes of worse prognosis .