缺血性脑卒中TOAST病因分型和预后

<title>assification and prognosis of ischemic stroke subtypes according to TOAST criteria: a prospective cohort study

目的了解住院缺血性脑卒中患者TOAST病因分型的构成,分析不同亚型与预后的关系。方法采用前瞻性队列研究方法,连续性登记2002年3月至2003年3月间入院的缺血性脑卒中患者,按照TOAST标准进行病因分型,分析TOAST各亚型与预后的关系。结果共纳入缺血性脑卒中患者321例。TOAST各亚型构成比如下:不明原因型36.1％,小动脉闭塞型29.6％,心源性栓塞型23.7％,大动脉粥样硬化型9.7％,其他明确病因型0.9％。各型6个月末病死率比较,心源性栓塞型最高(27.6％),小动脉闭塞型最低(1.1％),差异有显著意义(P<0.05)。各型6个月末死亡／残疾率比较,大动脉粥样硬化型最高(45.2％),小动脉闭塞型最低(7.4％),差异有显著意义(P<0.05)。各型6个月末复发例数较少,结论尚有待进一步验证。结论TOAST分型作为一种缺血性脑卒中病因分型方法,可以为缺血性脑卒中的预后估计和复发的预防提供参考依据。

<abstract>jective To analysis the proportion and prognosis of ischemic stroke subtypes according to the TOAST riteria Methods Data were collected prospectively from consecutive stroke inpatients in West China Hospital, ichuan University from March 2002 to March 2003. After completing medical records and auxiliary diagnostic tudies, all included patients were classified into 5 major ischemic stroke subtypes based on TOAST criteria. omparing the roportion of death or disability, death, and recurrence of TOAST subtypes of in 6-month after schemic stroke. Results Three hundred and twenty-one patients were included in this study. The proportion of ischemic stroke subtypes ccording to TOAST criteria was as follows: stroke of undetermined etiology 36. 1% , small-vessel occlusion 29.6% , ardioembolism 23.7% , large-artery atherosclerosis 9.7% , stroke of other determined etiology 0. 9% . Small-vessel occlusion is the most frequent subtype among the other subtypes of determined cause, associated with the lowest stroke severity and morbidity, and had the best outcome. Cardioembolism, had the worst outcome and highest orbidity among TOAST subtypes. The recurrence rate was low. Conclusion TOAST criterion should be useful to stimate the prognosis of stroke. It is feasible to use TOAST criterion in China.