青年脑梗塞脑动脉狭窄危险因素的分析

The risk factor analysis of cerebral artery stenosis in youth patient with cerebral infarction

目的探究青年脑梗塞患者脑动脉狭窄的可能危险因素。方法收集住院治疗的青年脑梗塞患者270例。进行病史、家族史等询问,行血液学检查及经颅多普勒超声(TCD)、颈动脉彩色多普勒超声(CDFI)、CT血管造影(CTA)等脑血管检查。按有无脑动脉狭窄将270例患者分为狭窄组和非狭窄组,对可能的血管狭窄危险因素进行统计分析。结果 270例青年脑梗塞患者中,女100例(37%),男170例(63%);非狭窄组88例,狭窄组182例(67.41%);狭窄组中单纯颅内动脉狭窄72例(39.56%),单纯颅外动脉狭窄46例(25.27%),同时合并脑动脉狭窄64例(35.16%);颅内动脉狭窄的总发生率为74.73%,颅外动脉狭窄的总发生率为60.44%;狭窄组可能的危险因素包括男性、吸烟、饮酒、高血压、糖尿病、高尿酸血症、高低密度脂蛋白、低高密度脂蛋白、高胆固醇、高甘油三酯、高载脂蛋白A、高载脂蛋白B及高脂蛋白a。结论 1脑动脉狭窄是青年脑梗塞的重要危险因素;2青年脑梗塞患者颅内动脉狭窄发生率较颅外动脉狭窄发生率高;3男性、吸烟、饮酒、高血压、糖尿病、高尿酸血症、高低密度脂蛋白、低高密度脂蛋白、高胆固醇、高甘油三酯、高载脂蛋白A、高载脂蛋白B及高脂蛋白a等因素与青年脑梗塞患者脑动脉狭窄相关。

Objective To youth patient with cerebral analyze the possible risk factors of the cerebral artery stenosis in infarction. Methods Two hundred and seventy youth cases of cerebral infarction treated in hospital were collected. The patients and their families were ques- tioned, with the medical history, family history, checking tests of hematology, cerebrovascular examination and other necessary auxiliary examination. Cerebrovascular examination including： transcranial color Doppler （TCD）, color Doppler flow imaging （CDFI）, computerized tomo- graphy angiography （CTA）. Patients were divided into stenosis group and non stenosis group according to the presence of stenosis, the possible risk factors were statistically analyzed. Resuits Of the 270 youth patients with cerebral infarction, there were 100 females （37%） and 170 males （63%） ; 88 cases in unstenosis group, and 182 cases in stenosis group, accounting for 67.41% ; the pure intracranial artery stenosis included 72 cases （39.56%）, while only extracranial artery stenosis were 46 cases （25.27%）, and both intracranial and extracranial artery stenosis were 64 cases （35.16%）; the incidence of intracranial artery stenosis was 74. 73% , and the incidence of extracranial artery stenosis was 60. 44% in total; the risk factors for stenosis groups to the other group were the results of men, smoking, drinking, hypertension, diabetes, high uric acid, high LDL-c, low HDL, high TC, high TG, high apolipoprotein A, apolipoprotein B and high lipoprotein a. They were associated with both the intracranial and extracranial artery stenosis, might be the possible risk factors. Conclusion ①The cerebral artery stenosis is the risk factor of cerebral infarction in youth patients ; ②The incidence of intracranial artery stenosis in youth patients with cerebral infarction is higher to the extracranial artery stenosis ;③The factors of men, smoking, drinking, hypertension, diabetes, high uric acid, high LDL-c, low HDL, high TC, high TG, high apolipoprotein A and apolipoprotein B, and high lipoprotein a and so on, are related to the artery stenosis .