青年卒中190例病因及危险因素分析

Analysis of Causes and Risk Factors in Young People with Apoplexy(a report of 190 cases)

目的探讨青年卒中的病因和危险因素。方法回顾分析18～40岁急性脑卒中190例的临床资料。结果 190例中,缺血性卒中111例,出血性卒中79例,前者有病因可寻的96例,其中动脉粥样硬化性脑梗死63例(56.8%)、血管炎9例(8.1%)、烟雾病7例(6.3%)、心源性栓塞6例(5.4%)、血流动力学异常4例(3.6%)、先天性血管发育异常2例(1.8%)、偏头痛性梗死2例(1.8%)、线粒体脑肌病2例(1.8%)、抗心磷脂抗体综合征1例(0.9%)、出血性卒中中、高血压性39例(49.4%)、血管畸形11例(13.9%)、动脉瘤7例(8.9%)、烟雾病1例(1.3%)、凝血机制障碍1例(1.3%)、病因未明20例(25.3%)。主要的危险因素有高血压、高脂血症、吸烟、饮酒、TIA、高同型半胱氨酸血症、糖尿病、心脏病、偏头痛、家族史等。结论青年卒中患者病因和发病危险因素复杂。

Objective To study the causes and risk factors in young people with apoplexy.Methods The clinical data of 190 cases of stroke whose ages were 18～40 were retrospectively anahzed.Results Of 190 cases, there were 111 cases of ischemic apoplexy,79 cases of hemorrhagic apoplexy.Among 96 cases of ischemic apoplexy whose causes were known,there were 63 cases of atherosclerotic cerebral infarct(56.8%),9 cases of vasculitis (8.1%),7 cases of aerosol illness(6.3%),6 cases of cardiogenic infarct(5.4%),4 cases of hemodynamic illness (3.6%),2 cases of congenital vascular developmental anomaly(1.8%),2 cases of migraine infarct(1.8%),2 cases of mitochondrial brain myopathy(1.8%),1 case of anticardiac phospholipid antibody syndrome(0.9%).Among 79 cases of hemorrhagic apoplexy,there were 39 cases of hypertension(49.4%),11 cases of vascular deformity (13.9%),7 cases of aneurism(8.9%),1 case of aerosol illness(1.3%),1 case of blood coagulation mechanism disorder(1.3%),and 20 cases of unknown causes(25.3%).Main risk factors included hypertension,hyperlipemia, smoking,drinking,TIA(transient ischemic attack),hyperhomotypic cysteinemia,diabetes,heart disease,migraine, family history,etc.Conclusion Causes and attack risk factors of young people with apoplexy are complicated.