青壮年男性司机脑梗死的临床特征病因及危险因素分析

目的探讨青壮年男性司机脑梗死的临床特点、病因及危险因素。方法回顾性分析2010年1月至2015年1月收治的44例青壮年男性司机脑梗死患者病例，平均年龄（46．1±5．6）岁，对其临床特点、病因分型、危险因素进行分析。选取同期住院盼188例非职业司机的青壮年男性脑梗死患者为对照组，比较两组之间的差异。结果青壮年男性脑梗死患者中职业司机组的平均年龄低于对照组（P〈0．05）。职业司机组平均BMI指数为（27．2±3．2）kg／m2，对照组平均BMI指数为（25．1±2．9）kg／m2。职业司机组平均BMI指数高于对照组（P〈0．05）。两组在梗死部位方面有明显差异（P〈0．05），职业司机组中前循环31例（70．5％），对照组前循环96例（51．1％）。职业司机组主要危险因素以高脂血症（79．5％）、高血压病（72．7％）、大量吸烟（68．2％）最为常见。其中职业司机组大量吸烟、高血压病、糖尿病、高脂血症、高尿酸血症、HHCY暴露率高于对照组（P〈0．05）。职业司机组的TOAST病因分型以大动脉粥样硬化性卒中17例（38．6％）、小动脉闭塞性卒中14例（31．8％）在卒中分型中构成比最高。而对照组卒中分型构成比以大动脉粥样硬化性卒中79例（42．0％）、不明原因型56例（29．9％）最高。结论青壮年男性职业司机脑梗死患者临床常见，发病年龄相对较小，病情相对较重。危险因素以高脂血症最为常见，其次为高血压病、大量吸烟。应积极治疗，并在青壮年男性职业司机中针对危险因素进行筛查及一级预防，减少缺血性脑卒中的发生。

Objective To explore the clinical features, etiology and risk factors of young male drivers with cerebral infarction. Methods 44 cases of young and middle-aged male drivers with cerebral infarction from January 2010 to January 2015 in our hospital were retrospectively analyzed, and the clinical characteristics, etiology and risk factors were summarized and analyzed. 188 cases of young and middle-aged male cerebral infarction whose occupations were not driver were selected as control group and the differences between the two groups were compared. Results The average age of the professional group was lower than that of control group （ P〈0.05 ） .The average BMI index of the professional driver group was 27.2 ± 3.2 kg/m2, and the average BMI index of the control group was 25.1 ±2.9 kg/m〈 The former was higher than the latter, the difference was statistically significant （ P〈0.05 ） .There were differences in locations of cerebral infarction between two groups （ 10〈0.05 ） , with 31 cases （ 70.5% ） of anterior cerebral infarction in the professional driver group, 96 cases （ 51.1% ） of anterior cerebral infarction in the control group. The highest exposure ratios of risk factor were hypedipidemia （ 79.5% ） , hypertension （ 72.7% ） and heavy smoking （ 68.2% ） . The exposure ratios of professional driver group were higher than those in control group （ 10〈0.05 ） , including heavy smoking, hypertension, hyperlipidemia, hyperuricemia and hyperhomocysteinemia. Regarding TOAST stroke subtype, large-artery atherosclerosis （ LAA ） were diagnosed in 17 cases （ 38.6% ） , small artery occlusion （ SAO ） in 14 cases （ 31.8% ） in the professional driver group. LAA were diagnosed in 79 cases （ 42.0% ） , stroke of undemonstrated etiology （ SUE ） in 56 cases （ 29.9% ） in the control group.Conclusions Young and middle-aged male professional drivers of cerebral infarction are common in clinical practice with young age of onset and serious symptoms. The most common risk factor is hyperlipidemia, followed by hypertension and heavy smoking. The cerebral infarction of young and middle-aged male professional drivers should be actively treated. At the same time, screening and primary prevention of risk factors in the young and middle-aged male professional drivers should be performed to reduce the occurrence of ischemic stroke.