青年与中老年缺血性脑卒中的临床特征分析

Analysis on Clinical Characteristics of Ischemic Stroke in Young,Middle-Aged and Elderly Patients

目的:探讨青年与中老年缺血性脑卒中的临床特征。方法:选取2021年4月—2022年3月广东省普宁市人民医院神经内科收治的530例缺血性脑卒中患者为研究对象,其中50例青年患者为观察组,480例中老年患者为对照组,记录两组患者危险因素、核磁共振(MRI)和血管学评估及转归判断。比较两组危险因素、病灶分布、血管狭窄分布及预后。结果:观察组患高血压比例低于对照组,抗心磷脂抗体阳性率高于对照组,差异有统计学意义(P<0.05);两组患糖尿病、高脂血症、同型半胱氨酸、心房颤动、室间隔缺损的比例比较,差异无统计学意义(P>0.05)。观察组放射冠区、基底节区病灶占比高于对照组,差异有统计学意义(P<0.05);两组脑叶、丘脑、脑干、小脑、胼胝体及其他多发病灶分布占比比较,差异无统计学意义(P>0.05)。两组大脑前动脉、大脑中动脉、大脑后动脉、基底动脉、椎动脉、颈内动脉、多发血管狭窄分布比较,差异无统计学意义(P>0.05)。观察组恢复良好率高于对照组,残疾、复发、死亡率均低于对照组,差异有统计学意义(P<0.01)。结论:青年与中老年缺血性脑卒中患者危险因素不同,病灶分布有差异,血管狭窄病变趋于一致,青年患者预后较好。

Objective:To explore the clinical characteristics of ischemic stroke in young,middle-aged and elderly patients.Methods:From April 2021 to March 2022,530 patients with ischemic stroke who were admitted to Department of Neurology,People's Hospital of Puning City in Guangdong Province were selected as the study subjects,including 50 young patients in the observation group,and 480 middle-aged and elderly patients in the control group.Risk factors,magnetic resonance imaging(MRI)and angiography evaluation,as well as clinical outcome judgement in two groups were recorded.The risk factors,distribution of lesions,distribution of vascular stenosis and prognosis in the two groups were compared.Results:The proportion of patients with hypertension in the observation group was lower than that in the control group,and the positive rate of anticardiolipin antibody in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the proportions of patients with diabetes,hyperlipidemia,homocysteine,atrial fibrillation,and ventricular septal defect between the two groups(P>0.05).The proportions of lesions in the radiation crown area and basal ganglia area in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the distribution proportions of lesions in brain lobes,thalamus,brainstem,cerebellum,corpus callosum and other multiple foci between the two groups(P>0.05).There was no significant difference in the distribution of anterior cerebral artery,middle cerebral artery,posterior cerebral artery,basilar artery,vertebral artery,internal carotid artery and multiple vascular stenosis between the two groups(P>0.05).The good recovery rate in the observation group was higher than that in the control group,and the disability,recurrence and mortality rates in the observation group were lower than that in the control group,and the difference was statistically significant(P<0.01).Conclusion:There are differences in risk factors and focus distribution in young,middle-aged and elderly patients with ischemic stroke,but the vascular stenosis lesion trend is similar,and young patients have better prognosis.