青年卒中与中老年卒中危险因素和病因分型对比研究

A comparative study on risk factors and etiological classification of stroke in middle-aged and middle-aged adults

目的分析青年缺血性卒中患者的危险因素和病因分型,并与老年性缺血性卒中患者进行对比,为进一步提高青年缺血性卒中的预防及诊疗水平提供依据。方法选取2018年1月至2019年6月北京市首都医科大学大兴医院神经内科收治的青年急性缺血性脑卒中患者80例,随机抽取同期住院中老年急性缺血性卒中患者80例进行对比分析。记录两组患者临床资料,包括吸烟、饮酒史、高血压病史、糖尿病病史、冠心病病史、脑卒中病史,以及患者血液生化指标,包括血常规、空腹血糖、糖化血红蛋白、甘油三酯、总胆固醇、高、低密度脂蛋白胆固醇、尿酸、同型半胱氨酸。统计分析两组患者的一般资料、危险因素、病因分型。结果青年组患者的年龄显著小于中老年组(P<0.05),但两组患者的性别、瘫痪部位等临床资料比较差异无统计学意义。青年组患者合并高血压、糖尿病、冠心病、既往卒中均显著低于中老年组(P<0.05),合并高同型半胱氨酸血症比例显著高于中老年组(P<0.05),但两组患者合并高脂血症比例比较差异无统计学意义,吸烟、饮酒比例比较差异也均无统计学意义。青年组患者的TOAST病因分型大动脉粥样硬化性卒中、小动脉闭塞性卒中、心源性卒中比例均显著低于中老年组(P<0.05),其他原因卒中、不明原因卒中均显著高于中老年组(P<0.05)。结论青年卒中与中老年卒中危险因素和病因分型不同,值得临床充分重视。

Objective To analyze the risk factors and etiological classification of young patients with ischemic stroke,and compare them with elderly patients with ischemic stroke,so as to provide basis for further improving the prevention and treatment level of young patients with ischemic stroke.Methods 80 young patients with acute ischemic stroke in Department of Neurology,Daxing hospital,Capital Medical University of Beijing from January 2018 to June 2019 were selected,and 80 elderly patients with acute ischemic stroke were randomly selected for comparative analysis.The clinical data of the two groups were recorded,including smoking,drinking history,hypertension history,diabetes history,coronary heart disease history,stroke history;and blood biochemical indicators,including blood routine,fasting blood glucose,glycosylated hemoglobin,triglycerides,total cholesterol,high and low-density lipoprotein cholesterol,uric acid,homocysteine.Then statistical analysis of the two groups of patients with general information,risk factors,etiology classification.Results The age of the young group was significantly less than that of the middle-aged group(P<0.05),but there was no significant difference between the two groups in terms of gender,paralytic site and other clinical data.The youth group with hypertension,diabetes,coronary heart disease,stroke were significantly lower than the middle-aged group(P<0.05),and the proportion of hyperhomocysteinemia was significantly higher than that of the middle-aged group(P<0.05),but there was no significant difference between the two groups in the proportion of hyperlipidemia,smoking and drinking.The proportion of toast etiology classification in youth group was significantly lower than that in middle-aged and elderly group(P<0.05),and the proportion of stroke of other causes and unknown causes was significantly higher than that of middle-aged and elderly group(P<0.05).Conclusion The risk factors and etiological types of young stroke and middle-aged and elderly stroke are different,which is worthy of clinical attention.