青年缺血性脑卒中TOAST分型的临床意义

The subtypes of ischemic stroke TOAST criteria in young adults

目的采用TOAST分型法研究青年缺血性脑卒中的特征。方法收集64例15～45岁急性缺血性脑卒中患者,并经头部CT或MRI证实;所有患者均行胸部X线、心电图、血常规、血糖、血脂、凝血功能及血管炎方面的检查,多数患者做了血管方面的检查;脑卒中依据TOAST标准分型。结果青年缺血性脑卒中男性患者所占比例较女性患者明显增高,脑卒中亚型;大动脉粥样硬化性脑卒中占21.9%,小动物闭塞脑卒中占32.8%,心源性脑栓塞占18.8%,其他原因引发的缺血性脑卒中占15.6%,原因不明的缺血性脑卒中占10.9%。15～35岁患者心源性脑栓塞和其他原因引发的缺血性脑卒中占相对高的比例;35岁以上患者大动脉粥样硬化性脑卒中及小动脉闭塞性脑卒中占相对高的比例。吸烟、酗酒的男性患者比例较女性患者显著增高,女性患者高血压病的比例较男性患者增多。结论根据TOAST分型及危险因素的研究结果,对不同年龄层次的青年缺血性脑卒中患者有不同的临床意义。

Objective To evaluate the characteristics of ischemic stroke in young adults. Methods We studied 64 patients with acute ischemic stroke aged between 15 to 45 years. All patients were performed cranial CT/MRI and chest x-ray, electrocardiogram, complete blood counts, blood glucose, lipid profile, coagulation tests and intra or extracranial vessel tests. The most of them had images for cerebral vessels. Stroke subtypes were classified by TOAST criteria. Results In our study, The incidence in men was significantly higher than women. Stroke subtypes included large artery atherosclerosis 21.9%, small artery occlusive disease 32. 8%, cardioembolism 18. 8 %, other vascular disorders 15. 6 %, and undetermined cause 10.9 %. The causes of majority of patients aged between 15 to 35 years were cardioembolism and other vascular diseases. The cause of majority of patients aged between 36 to 45 years were large artery atherosclerosis and small artery occlusive disease. The prevalence of cigarette smoking and alcohol abuse was significantly higher in men than in women. The prevalence of hypertension was higher in women than in men. Conclusions There was different clinical meaninge for different age in young patients by TOAST stroke subtypes and risk factors.