青年人脑梗死186例临床分析

Clinical analysis of 186 young cases of cerebral infarction

目的分析青年人脑梗死的病因、危险因素、临床特点及预后。方法回顾性分析186例青年人脑梗死的临床资料。结果主要危险因素有:高血压病、酗酒、吸烟、高血脂和家族史。有明确病因者166例(89.25%),病因不清者20例(10.75%),其中动脉粥样硬化92例(49.46%),炎症性血管病20例(10.75%),先天性脑血管畸形7例(3.76%),心源性栓塞16例(9.64%),偏头痛诱发4例(2.82%),血液病6例(3.23%),头部外伤诱发6例(3.23%)。临床特点为:男性多见,意识障碍少,以偏身感觉障碍及偏瘫为主,预后较好,经治疗本组痊愈136例(73.12%),显著进步42例(22.58%),死亡8例(4.30%)。结论青年人脑梗死主要危险因素是高血压、吸烟、酗酒和高血脂症,病因复杂多样,但仍是以动脉粥样硬化最多见,其次是血管炎及心脏疾患。预后较好,治愈率高,致残率、死亡率较低。

[Objective] To analysis causes, risk factors, clinical features and prognosis of cerebral infarction in young patients. [Methods] Resropective study of clinical data 186 patients with youth cerebral infarction was carfled out. [Results] The main risk factors were： hypertention, alcohol abuse, smoking, hyperlipidemia, family history. In all of these patients, 166 patients confirmed with definite pathogeny（89.25%）, 20 patients had unclear pathogeny （10.75%）. 92 patients have atherosclerosis（49.46%）, 20 patients have arteritis（10.75%）, 7 patients have cerebral vascular malformation（3.76%）, 16 patients had heart origin embolism（9.64%）, 4 patients had migraine（2.82%）, 6 patients had blood system＇s disease（3.23%）, 6 patients is related to trauma（3.23%）. The clinical features were： the males were more common, the disorders of conciousness was mild, they were mostly manifested with hemiplegia and hemi-sensedisorder; the prognosis was well; after treatment, 136 patients recovered（73.12%）, 42 patients got notable advancement（22.58%）, 8 patients died（4.30%）. [Conclusion] The main risk fators in youth cerebral infarction was hypertention, smoking, alcohol abuse, hyperlipidemia. The causes are comphcatied, the mostly common one is atherosclerosis, arteritis and heart diseaserank the second. The prognosis is well, the cure rate is high, the mortality and morbality are low.