【摘要】 目的本研究目的是确定自发性蛛网膜下腔出血(SAH)的危险因素。方法 2009年1月-2011年12月在内蒙古包头市城区进行前瞻的、基于人群的、1:2配比的病例对照研究,由内蒙古包头市拥有神经内科和(或)神经外科的综合性医院、小型医院和部队医院等多中心共同收集包头市城镇居民中自发性SAH病例(年龄≥15岁)。每个患者选2个对照组,为非SAH患者、同性别、年龄为患者年龄±5岁的包头市城镇居民。收集病例组和对照组有关病史、生活习惯、危险因素等信息。用Logistic回归分析评估主要危险因素与SAH的关系,并用相对危险度(RR)和95%可信区间(CI)表示。结果本研究共收集了226例确诊为自发性SAH的患者,其中65%为女性,发病年龄为20～87岁,平均年龄(58.5±13)岁,434例对照组。高血压、吸烟和低收入是SAH的主要危险因素。与不吸烟者相比,SAH患者中正在吸烟者的相对危险度(RR)为2.31(95%CI1.31～4.09),但是在女性患者,目前吸烟者和未吸烟的RR为4.00(95%CI1.62～9.89)。吸烟、高血压和低收入的人群归因危险度分别为18%、36%和59%。结论本研究显示自发性SAH的危险因素有高血压、吸烟和低收入,女性吸烟者患SAH的危险更高,如果控制吸烟和高血压,就会明显降低SAH的发病率。更多还原

【Abstract】 objective This study was to determine the risk factors of subarachnoid hemorrhage(SAH).Methods A prospective,population-based,1:2 matched case-control study was conducted in Baotou,Inner Mongolia in 2009-2011.All patients(age≥15 years) with spontaneous SAH were identified from multiple overlapping sources involving all major acute care hospitals with neurology/neurosurgery facilities,smaller hospitals and army hospital.For each case,two controls without SAH were matched according to gender,5-year age strata and sector of residence in Baotou.Controls were family members or friends of other patients with non-neurological conditions in hospital.Data on medical history and lifestyle factors were collected from cases and controls by interview of the subject or a proxy informant.Multivariable Logistic regression was used to assess associations of risk exposures and SAH,reported as risk ratios(RR) and population attributable risks(PAR) with 95% confidence intervals(CI).Results A total of 226 cases of SAH were identified,65% female with a mean age of 58.5 years(SD 13.2;range 20 to 87 years) with 434 controls.Hypertension,cigarette smoking and low income were the most important risk factors for SAH.Compared with non-smokers,the adjusted RR for SAH in current smokers was 2.31(95% CI 1.31 to 4.09) but for females it was 4.00(1.62 to 9.89).The PARs for current smoking,hypertension and low income were 18%,36% and 59% respectively.Conclusions This study showed that hypertension,smoking and low income are risk factors of spontaneous SAH,especially for female smokers.Public health measures to counter smoking and hypertension can reduce the burden of SAH in the population.更多还原