机构：[1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China首都医科大学宣武医院神经内科神经科系统[2]Department of Neurology, Yantai Penglai Traditional Chinese Medicine Hospital, Yantai 622110, China[3]Department of Neurology, Yushu People’s Hospital, Yushu 815000, China[4]Department of Neurology, Huzhu People’s Hospital, Haidong 810500, China[5]Laboratory of Hypoxia, Xuanwu Hospital, Capital Medical University, Beijing 100053, China首都医科大学宣武医院低氧医学研究室科技平台[6]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China神经科系统神经外科首都医科大学宣武医院
The detailed characteristics of strokes at high altitudes in diverse nations have not been extensively studied. We retrospectively enrolled 892 cases of first-ever acute ischemic strokes at altitudes of 20, 2550, and 4200 m in China (697 cases from Penglai, 122 cases from Huzhu, and 73 cases from Yushu). Clinical data and brain images were analyzed. Ischemic strokes at high altitudes were characterized by younger ages (69.14 ± 11.10 vs. 64.44 ± 11.50 vs. 64.45 ± 14.03, p < 0.001) and larger infract volumes (8436.37 ± 29,615.07 mm3 vs. 17,213.16 ± 47,044.74 mm3 vs. 42,459 ± 84,529.83 mm3, p < 0.001). The atherosclerotic factors at high altitude, including diabetes mellitus (28.8% vs. 17.2% vs. 9.6%, p < 0.001), coronary heart disease (14.3% vs. 1.6% vs. 4.1%, p < 0.001), and hyperlipidemia (20.2% vs. 17.2% vs. 8.2%, p = 0.031), were significantly fewer than those in plain areas. Polycythemia and hemoglobin levels (138.22 ± 18.04 g/L vs. 172.87 ± 31.57 g/L vs. 171.81 ± 29.55 g/L, p < 0.001), diastolic pressure (89.98 ± 12.99 mmHg vs. 93.07 ± 17.79 mmHg vs. 95.44 ± 17.86 mmHg, p = 0.016), the percentage of hyperhomocysteinemia (13.6% in Penglai vs. 41.8% in Huzhu, p < 0.001), and the percentage of smoking (33.1% in Penglai vs. 50.0% in Huzhu, p = 0.023) were significantly elevated at high altitudes. We concluded that ischemic stroke occurred earlier and more severely in the Chinese plateau. While the atherosclerotic factors were not prominent, the primary prevention of strokes at high altitudes should emphasize anticoagulation, reducing diastolic pressure, adopting a healthy diet, and smoking cessation.
基金：
the National Key R&D Program of China (2017YFC1307900,
2017YFC1307903) and “Sail Plan” Key Medical Specialty(ZYLX202139).
第一作者机构：[1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
通讯作者：
推荐引用方式(GB/T 7714)：
Liu Moqi,Yan Mingzong,Guo Yong,et al.Acute Ischemic Stroke at High Altitudes in China: Early Onset and Severe Manifestations.[J].CELLS.2021,10(4):doi:10.3390/cells10040809.
APA：
Liu Moqi,Yan Mingzong,Guo Yong,Xie Zhankui,Li Rui...&Guo Xiuhai.(2021).Acute Ischemic Stroke at High Altitudes in China: Early Onset and Severe Manifestations..CELLS,10,(4)
MLA：
Liu Moqi,et al."Acute Ischemic Stroke at High Altitudes in China: Early Onset and Severe Manifestations.".CELLS 10..4(2021)
