青、老年脑梗死患者的危险因素及病因分析

The risk factors and etiology of cerebral infarction in the young people and the aged people

目的探讨青、老年脑梗死的危险因素及病因特点。方法对我院2007年1月至2009年12月在我院收治的785例脑梗死病例资料进行分析,患者按年龄分为青年组(≤45岁;n=80)和老年组(≥65岁;n=705),就高血压病、糖尿病/葡萄糖耐量异常(IGT)、高脂血症、心脏病、中枢神经系统感染、高同型半胱氨酸血症(HCY)、颅内外动脉狭窄或闭塞、烟雾病等危险因素进行分析和比较。结果危险因素分析显示老年脑梗死患者高血压病、糖尿病/IGT的发生率显著高于青年患者(P<0.01);两组患者高脂血症、心脏病史的发生率无显著差异(P>0.05)。病因分析中枢神经系统感染、HCY、颅内外动脉狭窄或闭塞以及烟雾病的发生率显著高于老年患者(P<0.05)。结论高血压病、糖尿病/IGT是导致老年人发生脑梗死的主要高危因素;而HCY、中枢神经系统感染、烟雾病、颅内外动脉狭窄或闭塞则为导致青年脑梗死发生的重要病因。控制好这些危险因素以及病因治疗,对脑梗死的预防和预后具有重要的临床价值。

Objective To investigate the risk factors and etiology of the cerebral infarction in the young people and aged people. Methods 385 hospitalized patients with cerebral infarction were reviewed from Jan 2007 to Dec 2009, and the patients were grouped by age into two groups ： the youth group （ ≤ 45 years; n =80） and aged group （ ≥ 65 years; n =705 ）. the analytic and comparative risk factors or pathogeng of cerebral infarction between two groups included hypertension, diabetes , impaired glucose tolerance （IGT）, Hyperlipidemia, heart disease, central nervous system infections, hyperhomocysteinemia （HCY）, extracranial arterial stenosis or occlusion and moyamoya disease . Results The analysis of the partial risk factors display that hypertension and diabetes/IGT were significantly different between two groups （P〈0.01）, Hyperlipidemia and a history of heart disease were no differet between the two groups （P 〉 0.05） ; the analysis of the etiology display that the central nervous system infections, HCY, extracranial arterial stenosis or occlusion , moyamoya disease was significantly different between the two groups （P 〈 0.05 ）. Conclusion Hypertension and diabetes/IGT is a major risk factors in aged people with cerebral infraction ;however , HCY, central nervous system infections, moyamoya disease, cerebral artery stenosis or occlusion are the main etiology in young people with cerebral infarction, therefore, controlling of these risk factors and treating aimed at the etiopathogencsis have great important clinical values in cerebral infraction patients.