对青年缺血性脑卒中相关危险因素的再认识

Reconsideration for ischemic stroke risk factors in youth

目的：分析青年缺血性脑卒中的相关危险因素和睡眠质量在青年缺血性脑卒中的重要性。方法连续性收集2011年6月至2013年2月间，郑州大学第一附属医院与濮阳市人民医院住院的年龄在18～45岁，缺血性脑卒中首发患者219例作为观察组，其中男166例，女53例。同时连续性选取同期住院的年龄＞45岁的中老年人和体检青年人作为对照组，病情程度、男女比例及年龄比例与观察组匹配。分别为中老年对照组：年龄46～80岁，共计231例，男170例，女61例。青年对照组，年龄18～45岁，共149名。观察所有研究对象中，缺血性脑卒中相关危险因素及睡眠质量在诸多危险因素中的重要性，对青年缺血性脑卒中危险因素进行再认识。结果高血压史、高血脂、吸烟以及饮酒、睡眠质量、糖尿病史、卒中家族史、高同型半胱氨酸氨酸血症均与青年缺血性脑卒中的发病有关，其暴露率由高到低依次为：高血压史（64．8％）、吸烟（58．0％）、睡眠质量差（55．7％）、高脂血症（52．5％）、酗酒（47．5％）、高同型半胱氨酸血症（38．4％）、脑卒中家族史（35．2％）和糖尿病史（14．2％）。其中，睡眠质量差者55．7％，位于第3位。结论青年缺血性脑卒中危险因素与以往国内外研究存在差异；睡眠质量差是青年IS不可忽视的重要因素，在青年IS危险因素中占据较为重要的地位。

Objective To explore the related ischemic stroke （ IS ） risk factors in youth and the importance of sleep quality in young ischemic stroke .Methods A total of 219 patients aged 18 to 45 years （166 males, 53 females） with an initial onset of ischemic stroke from First Affiliated Hospital , Zhengzhou University and Puyang People′s Hospital during June 2011 to February 2013, were recruited as the study cases.Meanwhile 231 patients aged 46 to 80 years （170 males, 61 females） from the same hospitals were selected as the elderly control group .And 149 young persons aged 18 to 45 years undergoing normal physical examinations from the same hospitals were taken as youth control group .For all cases, their ischemic stroke related risk factors and especially the importance of sleep quality were analyzed .Prospective analyses were conducted to re-considerate the related ischemic stroke risk factors in youth .Results Hypertension history , high cholesterol, diabetes, smoking and drinking, bad sleep quality, family history of stroke and hyperhomocysteinemia were associated with the onset of young ischemic stroke .The decreasing exposure rates were history of hypertension , smoking, poor sleep quality, hyperlipidemia, alcoholism, hyperhomocysteinemia and a family history of stroke and diabetes .In ischemic stroke young patients , bad sleep quality accounted for 55.7%and ranked third among all risk factors .Conclusion The risk factors of young ischemic stroke ranks are different with other studies .As one of the most important factors for youth ischemic stroke, poor sleep quality should not be neglected .