目的:对比研究青年高血压脑出血与青年高血压非脑出血及青年体检者体内血脂水平与脑出血发病的关系,为今后临床预防青年高血压脑出血提供一定的理论依据。方法:选取2014年1月1日至2014年12月31日在徐州市中心医院神经外科、神经内科住院的青年高血压脑出血患者、门诊体检的高血压非脑出血青年、青年正常体检者(年龄≤45岁)各80例,分别检测其血脂水平,对比分析。结果:3组在性别、年龄及吸烟、饮酒史方面差异无统计学意义(P>0.05);与青年体检者相比,青年高血压脑出血组及青年高血压非脑出血组患者TG、TC、LDL-C水平均升高(P<0.05);与青年高血压非脑出血组相比,青年高血压脑出血组患者TG及TC水平明显升高(P<0.05),而3组间方差分析显示,HDL-C在3组间差异无统计学意义(P>0.05)。将青年高血压脑出血组与青年高血压非脑出血组患者合并进行Logistic回归分析,结果显示青年高血压脑出血与TG(OR=2.48)及TC(OR=3.35)水平相关,TG、TC水平越高青年高血压患者出现脑出血的危险性越大。结论:青年高血压脑出血患者中,血脂水平异常、尤其是TG、TC水平为主要危险因素。

[1] KOIVUNEN R J,TATLISUMAK T,SATOPÄÄ J,et al.Intracerebral hemorrhage at young age:long-term prognosis[J].Eur J Neurol,2015,22(7):1029-1037.
[2] THORSTEN S,MARKKU K,MARKKU K,et al.Recommendations for the management of intracranial haemorrhage-part Ⅰ:spontaneous intracerebral haemorrhage.The European Stroke Initiative Writing Committee and the Writing Committee for the EUSI Executive Committee[J].Cerebrovasc Dis,2006,22(4):294-316.
[3] 丁建.高血压与无高血压急性脑梗死患者发生脑微出血的对照研究[J].现代医学,2014,42(12):1411-1415.
[4] KOIVUNEN R J,SATOPÄÄ J,MERETOJA A,et al.Incidence,risk factors,etiology,severity,and short-term outcome of non-traumatic intracerebral hemorrhage in young adults[J].Eur J Neurol,2015,22(1):123-132.
[5] EDWARD F,JOSEPH P B,WALTHER N K,et al.Major risk factors for intracerebral hemorrhage in the young are modifiable[J].Stroke,2005,36:1881-1885.
[6] TSIVQOULIS G,PUTAALA J,SHARMA V K,et al.Racial disparities in early mortality in 1,134 young patients with acute stroke[J].Neurol Sci,2014,34(7):1041-1049.
[7] 徐兵.青年人高血压脑出血61例临床分析[J].现代医学,2008,36(6):465-466.
[8] RUÍZ-SANDOVAL J L,CANTU＇C,BARINAGARREMENTERIA F.Intracerebral hemorrhage in young people:analysis of risk factors,location,causes,and prognosis[J].Stroke,1999,30(3):537-541.
[9] 郭志荣,胡晓抒,武鸣,等.血脂与高血压关系的前瞻性研究[J].中华流行病学杂志,2009,30(9):864-864.
[10] PAOLO P,DANIELE L,VANIA Z,et al.Evolution of blood pressure and cholesterol in stage 1 hypertension:role of autonomic nervous system activity[J].J Hypertens,2006,24(7):1375-1381.
[11] SANDER G E,GILES T D.Hypertension and lipids:lipid factors in the hypertension syndrome.syndrome[J].Curr Hypertens Rep,2002,4(6):458-63.
[12] HEMPHILL J C 3rd,GREENBERG S M,ANDERSON C S,et al.Guidelines for the management of spontaneous intracerebral hemorrhage:a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J].Stroke,2015,46(7):2032-2060.
[13] 中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志,2011(7):579-616.
[14] RUIZ-SANDOVAL J L,SAMUEL R V,ERWIN C,et al.Hypertensive intracerebral hemorrhage in young people:previously unnoticed age-related clinical differences[J].Stroke,2006,37(12):2946-2950.
[15] GONZÁLEZ S,FERNÁNDEZ O,FERNÁNDEZ R,et al.Association between blood lipids and types of stroke[J].Medic Rev,2008,10(2):27-32.
[16] ZIA E,PESSAH-RASMUSSEN H,KHAN F A,et al.Risk factors for primary intracerebral hemorrhage:a population-based case-control study[J].Cerebrovasc Dis,2006,21(1-2):18-25.
[17] WANG X,KONG Y,CHEN H,et al.Characteristics of acute cerebral hemorrhage with regard to lipid metabolism and glycometabolism among different age groups[J].Acta Neurochir Suppl,2011,111:367-371.
[18] DANIEL W,KISSELA B M,KHOURY J C,et al.Hypercholesterolemia,HMG-CoA reductase inhibitors,and risk of intracerebral hemorrhage:a case-control study[J].Stroke,2004,35(6):1360-1364.
[19] MCKINNEY J S,KOSTIS W J.Statin therapy and the risk of intracerebral hemorrhage:a meta-analysis of 31 randomized controlled trials[J].Stroke,2012,43:2149-2156.