青年缺血性卒中患者前后循环发病相关因素研究

Etiology and Risk Factors of Anterior Versus Posterior Circulation Stroke in Young Adults

目的对比前循环和后循环青年缺血性卒中患者的临床特征及病因分型特点。方法将2010年8月-2017年9月于上海市第一人民医院神经内科病房住院的18～55岁缺血性卒中患者纳入研究,通过回顾性收集患者的临床资料,分析青年患者前后循环缺血性卒中的临床特征及病因分型之间的区别。结果研究纳入678例青年缺血性卒中患者,其中包括203例(29.9%)后循环卒中及475例(70.1%)前循环卒中。高血压均是两组最常见的危险因素,分别占前循环卒中的68.6%和后循环卒中的66%。多因素回归分析提示糖尿病(OR 1.569,95%CI 1.082～2.277)作为危险因素对后循环发挥的作用更大。结论青年前、后循环缺血性卒中的病因学和危险因素分布大体相似,糖尿病作为危险因素对后循环发挥的作用更大。

Objective To compare the difference of etiology and risk factor between anterior and posterior circulation infarction in young adults.Methods A retrospective analysis of 678 ischemic stroke patients aged 18-55 years old in Shanghai General Hospital from August 2010 to September 2017 were conducted,to analyze the difference of clinical characteristics and TOAST etiological subtype between anterior and posterior circulation stroke in young patients.Results Of total 678 patients,203(29.9%)patients in posterior circulation and 475(70.1%)in anterior circulation.The most common risk factor in the two groups was hypertension,the prevalence of hypertension was 66%in posterior circulation group and 66.8%in anterior circulation group.Multivariable logistic analysis indicated diabetes mellitus as a risk factor contributed greater in posterior circulation stroke than in anterior circulation stroke(OR 1.569,95%CI 1.082-2.277).Conclusions The etiology and risk factors of posterior circulation and anterior circulation stroke in young adults were similar.Diabetes mellitus as a risk factor contributed greater in posterior circulation stroke than in anterior circulation stroke.