青年脑梗死危险因素与TOAST分型的相关性研究

Association study of risk factors and TOAST classification in young patients with cerebral infarction

目的探讨青年脑梗死患者危险因素与临床TOAST分型的相关性。方法收集连续入院的首发急性青年脑梗死患者(年龄≤45岁)80例,分析青年脑梗死患者TOAST分型各型的比例及与危险因素的相关性。结果 TOAST亚型构成,心源性脑栓塞型17.5%(14/80),大动脉粥样硬化性脑梗死16.3%(13/80),小动脉脑梗死23.7%(19/80),其他原因所致脑梗死10%(8/80),原因不明的脑梗死32.5%(26/80)。危险因素依次为高血压46.3%(37/80)、高脂血症23.8%(19/80)、糖尿病17.5%(14/80)、吸烟史37.5%(30/80)、饮酒40%(32/80)、心脏病21.3%(17/80)、高同型半胱氨酸血症26.3%(21/80)。高脂血症在小动脉脑梗死分型中所占比例高(52.6%,χ2=11.5,P<0.05)。结论青年脑梗死组以原因不明型所占比例最高,危险因素以高血压所占比例最多,高脂血症在小动脉脑梗死发生中的影响更加明显。

Objective To explore the correlation between the risk factors of young patients with cerebral infarction and clinical TOAST typing. Methods 80 cases with registered first acute cerebral infarction in young patients （age ≤45 years old） were retrospectively analyzed. And accordance with the TOAST classification criteria of the 80 patients and related risk factors of patients at the same time, then we analyzed the proportion of young patients with cerebral infarction and correlation between the risk factors with TOAST typing. Results The proportion of isehemic stroke subtypes according to TOAST criteria was as follow： stroke of cardiogenie cerebral embolism （CE） was 17.5 %, large artery atherosclerotie cerebral infarction cerebral infarction （LAA） was 16.3 %, small artery cerebral infarction （SAA） was 23.7% ;cerebral infarction of other causes （SOE） was 10%. And cerebral infarction of unknown origin （SUE） was 32.5 %. The highest exposure ratios of risk factors were hypertension （46.3 % ）, blood lipid abnormality （23.8%）, diabetes （17. 5% ） ,smoking （37.5%） ,aleoholconsumption （40%） ,eardlopathy （21.3%） and high hyperhomocysteinemia 26.3% （21/80）. Univariate analysis of the risk factors in blood lipid abnormality increased significantly in the small artery cerebral infarction （52.6% ,χ2 = 11.5,P 〈 0.05 ）. Conclusion The SUE subtypes are the most common etiological types in young adults. The most ratios of risk factors are hypertension. Blood lipid abnormality is more significant in patients with small artery cerebral infarction.