摘要目的:探讨高原地区世居人群与旅居人群高血压脑出血患者的临床特点和预后情况。方法:回顾性分析2020年9月至2022年10月拉萨市人民医院神经外科收治的106例高血压脑出血患者的临床资料。其中长期居住高原地区的患者70例(世居组)，旅居患者36例(旅居组)。比较两组患者的人口学资料、既往史、原发性高血压或糖尿病病史、原发性高血压病程、脑血肿量、实验室相关检查指标、治疗方式、住院时长、预后等的差异。结果:与世居组比较，旅居组患者的年龄偏低[(54.4±7.3)岁对比(63.8±12.0)岁， t＝－4.28， P＝0.001]，既往有原发性高血压病史的占比更低[75.0%(27/36)对比95.7%(67/70)， χ2＝2.58， P＝0.001]，高血压病程更短[>5年者的比例分别为22.2%(8/36)和42.9%(30/70)， χ2＝2.82， P＝0.006]、脑干出血的占比更高[13.9%(5/36)对比7.1%(5/70), χ2＝2.37， P＝0.012]、而脑叶出血的占比偏低[13.9%(5/36)对比25.7%(18/70)， χ2＝3.58， P＝0.039]，血清血红蛋白水平更高[(185.6±30.0)g/L对比(166.8±31.1)g/L， t＝－3.03， P＝0.003]，住院时长更短[(12.9±8.9)d对比(18.4±14.2)d， t＝2.43， P＝0.017]、整体预后更佳[出院1、3个月，旅居组的中位改良Rankin量表评分(均为1分)均低于世居组(均为2分)，均 P<0.05]。而两组性别、入院时血压、血肿量等的差异均无统计学意义(均 P>0.05)。 结论:初步研究结果表明，旅居高原人群的高血压脑出血发病较世居人群更早，但整体预后情况更佳。

abstractsObjective:To investigate the clinical characteristics and outcomes of patients with hypertensive cerebral hemorrhage in the population of long-term residents and sojourners living in the plateau area.Methods:The clinical data of 106 patients with hypertensive cerebral hemorrhage admitted to the Department of Neurosurgery of Lhasa People′s Hospital of Tibet Autonomous Region from September 2020 to October 2022 were retrospectively analyzed. Among them, 70 patients lived in the plateau area for a long time (long-term residents group) and 36 patients migrated to the Tibet Autonomous Region (sojourners group). The differences in demographic data, history of hypertension or diabetes, duration of hypertension, hematoma volume, laboratory indexes, therapies, length of hospitalization and outcomes of the two groups were compared.Results:The sojourners group had a lower age (54.4±7.3 years vs. 63.8±12.0 years, t=-4.28, P=0.001), a lower proportion of previous hypertension [75.0% (27/36) vs. 95.7% (67/70), χ2=2.58, P=0.001], a shorter duration of hypertension [proportion of patients with disease duration longer than 5 years: 22.2% (8/36) vs. 42.9% (30/70), χ2=2.82, P=0.006], a lower proportion of brainstem hemorrhage [13.9% (5/36) vs. 7.1% (5/70), χ2=2.37, P=0.012], a higher proportion of cerebral lobe hemorrhage [13.9% (5/36) vs. 25.7% (18/70), χ2=3.58, P=0.039], a higher blood hemoglobin level (185.6±30.0 g/L vs. 166.8±31.1 g/L, t=-3.03, P=0.003)and a shorter length of hospital stay (12.9±8.9 d vs. 18.4±14.2 d, t=2.43, P=0.017)compared with the long-term residents group. At 1 and 3 months after discharge, the median modified Rankin scale score in the sojourners group (1 point at both time points) was lower than that in the long-term residents(2 points at both time points) (both P<0.05). There were no significant differences in gender, blood pressure or hematoma volume at admission (all P>0.05). Conclusion:Preliminary results showed that hypertensive intracerebral hemorrhage occurs earlier in sojourners than in long-term residents, while the overall outcome of sojourners seems better.