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目的探讨新疆汉族、维吾尔族、哈萨克族高血压患者发生腔隙性脑梗死危险因素的差异性。方法回顾性调查2012年1月至2015年5月高血压患者共1 319例,其中男700例,女619例。汉族746例,维吾尔族343例,哈萨克族230例,空腹采血,行动态血压、颈部血管超声等检查,对相关危险因素进行Logistic回归分析。结果汉族腔隙性脑梗死256例,维吾尔族腔隙性脑梗死112例,哈萨克族腔隙性脑梗死96例。汉族、维吾尔族、哈萨克族高血压患者发生腔隙性脑梗死的主要部位依次均为:双侧基底节区、半卵圆中心、放射冠。汉族高血压患者在额叶区腔隙性脑梗死的比例高于维吾尔族、哈萨克族;维吾尔族高血压患者在脑干区腔隙性脑梗死的比例高于汉族、哈萨克族;哈萨克族在放射冠、脑实质区腔隙性脑梗死的比例高于汉族、维吾尔族(P<0.05)。Logistic回归显示:年龄、血清胱抑素C、夜间SBP为汉族高血压患者发生腔隙性脑梗死的独立危险因素。年龄、血清胱抑素C、晨峰SBP、斑块、平均心率为维吾尔族高血压患者发生腔隙性脑梗死的独立危险因素,斑块阳性的维吾尔族高血压患者发生腔隙性脑梗死的风险为斑块阴性的患者的2.613倍。年龄、血清胱抑素C为哈萨克族高血压患者发生腔隙性脑梗死的独立危险因素。结论汉族、维吾尔族、哈萨克族高血压患者在额叶、脑干、放射冠、脑实质腔隙性脑梗死的比例不同,可能与各民族的遗传特质等不同相关。汉族、维吾尔族、哈萨克族高血压患者发生腔隙性脑梗死均与年龄、血清胱抑素C有关,但汉族还与夜间SBP相关,维吾尔族还与晨峰SBP、颈部血管斑块、平均心率相关。
Objective To investigate the differences of risk factors of lacunar infarction in hypertensive patients of Han, Uygur and Kazakans in Xinjiang Autonomous Region. Methods A total of 1 319 hypertensive patients from January 2012 to May 2015 were retrospectively investigated, including 700 males and 619 females. 746 Han, 343 Uygur, 230 Kazak, fasting blood collection, ambulatory blood pressure, neck vascular ultrasound and other related risk factors Logistic regression analysis. Results There were 256 cases of lacunar infarction in Han, 112 cases of lazy cerebral infarction in Uyghur and 96 cases of lacunar cerebral infarction in Kazak. The main parts of lacunar infarction in hypertensive patients of Han, Uygur and Kazakans were as follows: bilateral basal ganglia, semi-oval center and coronal. The prevalence of lacunar infarction in the frontal lobe of Han nationality is higher than that of the Uyghur and Kazak ethnic groups in Han nationality. The proportion of lacunar infarction in the hypertensive patients in the Uygur nationality is higher than that of the Han and Kazak peoples in the brainstem area. The proportion of lacunar infarction in the corona and corpus striatum was higher than that in Han and Uygur (P <0.05). Logistic regression analysis showed that age, serum cystatin C and nighttime SBP were independent risk factors of lacunar infarction in hypertensive patients of Han nationality. Age, serum cystatin C, morning peak SBP, plaque, and mean heart rate were independent risk factors for lacunar infarction in Uighur hypertensive patients. Lamellar cerebral infarction was found in plaque-positive Uighur hypertensive patients 2.613 times the risk of plaque-negative patients. Age, serum cystatin C is an independent risk factor for lacunar infarction in Kazakh patients with hypertension. Conclusions Han, Uygur and Kazak people have different proportions of frontal lobe, brainstem, coronae and cerebral parenchymal lacunar infarction, which may be related to the genetic traits of different ethnic groups. The incidence of lacunar infarction in Han, Uygur and Kazakens is related to age and serum cystatin C. However, Han is also associated with nocturnal SBP, and Uyghur is also associated with SBP in morning crest, cervical vascular plaque, Heart rate related.