中国大陆妊娠相关性脑卒中314例临床资料分析

目的：探讨中国大陆地区妊娠相关性脑卒中和蛛网膜下腔出血的危险因素及临床特点。方法：计算机检索中文生物医学数据库（CBMdisc）、万方数据库、维普数据库及中国知网数据库，检索年限均为2000年1月至2012年6月，对中国大陆地区已发表的与妊娠相关的脑卒中文献进行总结分析。结果：检索到18篇文献中314例符合纳入标准的病例。314例中脑出血179例，脑梗死110例，蛛网膜下腔出血25例。于妊娠晚期脑出血为102／179例，发病率为57．0％；妊娠中期脑梗死49／110例，发病率为44．5％；蛛网膜下腔出血25例，占总发病数的8．0％。子痢前期／子痫导致的脑出血42．4％（76／179例）；动脉瘤破裂导致的蛛网膜下腔出血56．0％（14／25例）；心源性栓塞导致的脑梗死29．1％（32／110例）。结论：妊娠相关性脑卒中好发于妊娠晚期及产褥期。脑梗死好发于妊娠中期，脑出血好发于妊娠晚期。脑出血常见病因为子痫前期／子痫，蛛网膜下腔出血常见病因为动脉瘤破裂（多发于妊娠晚期），脑梗死则为心源性栓塞。

Retrospective Analysis of 314 Cases with Stroke Related to Pregnancy in Mainland China

Aim： To analyze the clinical manifestations and risk factors of stroke related pregnancy. Methods： According to the method of systematic review in evidence-based medicine, CBMdisc, Wangfang, VIP and CNKI databases were searched from January 2000 to June 2012.314 cases with stroke related pregnancy were analyzed. Results： 18 trials （a total of 314 patients） were included. There were 179 patients with hemorrhage, of which 56.9% occured in late pregnancy. There were 110 patients with infarction, of which 44.5% occured in the mid-term pregnancy. There were 25 with subarachnoid hemorrhage（SAH）. Preeclampsia/eclampsia caused 42.5% of cerebral hemorrhage, aneurysm rupture subarachnoid hemorrhage 56%, cardiac embolism 29.1%. Conclusion： Stroke related pregnancy mostly occurs in the late pregnancy and puerperium. Cerebral infarction mostly occurs at mid-term pregnancy, while cerebral hemorrhage mostly occurs in the late pregnancy. Preeclampsia/eclampsia is a common reason. A large proportion of women with SAH suffer from rupture of aneurysms, which mostly happen in the late pregnancy.