缺血性脑卒中的病因分型与危险因素

Relationships between stroke etiological subtypes and risk factors in brain ischemia

目的探讨缺血性脑卒中病因分型与不同危险因素的关系。方法回顾性分析连续登记的急性缺血性卒中患者,记录其危险因素,并按急性卒中治疗试验(TOAST)标准将缺血性卒中分为5种类型分析相关危险因素对其发生风险的影响。结果在纳入分析的205例患者中,大动脉粥样硬化性卒中(LAA)100例(48.9%)、心源性卒中(CE)17例(8.3%)、小动脉闭塞性卒中(SAO)38例(18.5%)、其他原因所致卒中(SOE)12例(5.8%)、不明原因卒中(SUE)38例(18.5%)。分析显示,高血压与LAA的发生有关(OR=2.40,P=0.0028);心房颤动对CE发生有显著作用(OR=365.90,P<0.0001);饮酒与SAO的发生可能有一定关联(OR=2.73,P=0.036),而白细胞则在CE患者显著升高(OR=8.00,P=0.0013)。结论不同类型缺血性脑卒中与不同的危险因素有关。该结果对临床个体化预防与治疗有一定提示意义。

Objective To explore the relationships between stroke etiological subtypes and risk factors of cerebral infarction. Methods The clinical data of patients with acute cerebral infarction were analyzed retrospectively. Their diagnoses were established by imaging and other etiological examinations. The subtypes of patients were identified according to the Trial of Org10172 in Acute Stroke Treatment （TOAST） criteria, and their major risk factors were investigated and analyzed. Results There were 100 patients with large artery atherosclerotic cerebral infarction （LAA）, 17 with cardio embolism （CE）, 38 with small-artery occlusion （SAO）, 12 with stroke of other determined etiologies （SOE）, and 38 with stroke of undetermined etiologies （SUE）. Hypertension was associated with LAA significantly （OR=2.40, P=0.0028 ）. Atrial fibrillation had a significant （OR=365.90, P 〈 0.0001） relationship with CE. Alcoholic consumption could increase risk for SAO significantly （OR=2.73, P=0.036）. High white blood cell counts could was related significantly （OR=8.00, P=0.0013） with CE. Conclusions Different stroke subtypes in etiology could be associated with different risk factors, which may indicate us to improve the individual therapy in brain ischemia.