摘要：

目的: 总结海拔4000米以上高原地区脑卒中临床特征，并筛查出血性卒中危险因素。方法: 回顾分析2017年1月至2018年12月西藏自治区阿里地区人民医院收治的103例脑卒中患者（包括出血性卒中71例和缺血性卒中32例）临床资料，对比出血性卒中与缺血性卒中临床特征，单因素和多因素Logistic回归分析筛查出血性卒中危险因素。结果: 出血性卒中患者年龄低于缺血性卒中[（57.48 ± 10.81）岁对（64.03 ± 10.96）岁；t=2.836，P=0.006]，入院时收缩压[（171.92 ± 28.95）mm Hg对（141.81 ±23.24）mm Hg；t=5.174，P=0.000]和舒张压[（107.58 ± 18.76）mm Hg对（93.44 ± 14.94）mm Hg；t=3.757，P=0.000]、血红蛋白[（189.54 ± 28.12）g/L对（165.35 ± 25.42）g/L；t=4.111，P=0.000]以及总胆固醇[（4.60 ± 0.88）mmol/L对（4.04 ± 0.82）mmol/L；t=3.118，P=0.002]高于缺血性卒中。Logistic回归分析显示，入院时收缩压升高（OR=1.048，95% CI：1.024~1.073；P=0.000）和血红蛋白升高（OR=1.043，95% CI：1.015~1.072；P=0.002）是出血性卒中的危险因素。结论: 海拔4000米以上高原地区脑卒中以出血性卒中为主，入院时收缩压和血红蛋白较高的患者更易发生出血性卒中。

关键词: 卒中, 高海拔, 危险因素, Logistic模型

Abstract:

Objective: To summarize the clinical characteristic of stroke in the plateau area with altitude of 4000 m above, and to screen the risk factors of hemorrhagic stroke. Methods: The clinical data of 103 stroke patients (including 71 hemorrhagic stroke and 32 ischemic stroke) admitted to Ngari Prefecture People's Hospital of Tibet Autonomous Region from January 2017 to December 2018 were retrospectively analyzed, and the clinical characteristic of hemorrhagic stroke and ischemic stroke were compared. Univariate and multivariate Logistic regression analyses were used to screen the risk factors of hemorrhagic stroke. Results: The age of hemorrhagic stroke patients was lower than that of ischemic stroke patients [(57.48 ± 10.81) years vs. (64.03 ± 10.96) years; t=2.836, P=0.006], and the systolic blood pressure at admission [(171.92 ± 28.95) mm Hg vs. (141.81 ± 23.24) mm Hg; t=5.174, P=0.000], diastolic blood pressure [(107.58 ± 18.76) mm Hg vs. (93.44 ± 14.94) mm Hg; t=3.757, P=0.000], hemoglobin [(189.54 ± 28.12) g/L vs. (165.35 ± 25.42) g/L; t=4.111, P=0.000] and total cholesterol [(4.60 ± 0.88) mmol/L vs. (4.04 ± 0.82) mmol/L; t=3.118, P=0.002] were higher than those of ischemic stroke patients. Logistic regression analysis showed that systolic blood pressure on admission (OR=1.048, 95%CI: 1.024-1.073; P=0.000) and hemoglobin (OR=1.043, 95%CI: 1.015-1.072; P=0.002) elevation were risk factors of hemorrhagic stroke. Conclusions: Hemorrhagic stroke is the main type of stroke in the plateau area with altitude of 4000 m above. Patients with high systolic blood pressure on admission and hemoglobin are more likely to have hemorrhagic stroke.

Key words: Stroke, Altitude, Risk factors, Logistic models