青年脑梗死患者TOAST分型及危险因素的临床分析

发布时间：2018-02-24 02:04

本文关键词： 青年急性脑梗死 TOAST分型危险因素　出处：《南华大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：青年脑梗死是指18到45岁的脑梗死，通过观察99例青年急性脑梗死，探讨青年脑梗死的主要危险因素及其特点，以达到早期干预，早期发现，，早期预防，减少发病率和降低致残率的目的。方法：分析2011年10月-2013年10月我院神经内科18-45岁的急性脑梗死住院患者99例，入院后全部经我院的头颅CT或MRI证实，完善相关实验室检查，进行血管评估，并采用TOAST病因分型分析青年脑梗死的病因及危险因素。结果：（1）青年脑梗死发病率占同期所有脑梗死患者的4.38%，青年男女发病性别构成比为2∶1，青年脑梗死发病率还与人口分布、工作压力等相关。（2）随着年龄的增长，青年脑梗死发病率明显增加，其中36-45岁发病人数占青年脑梗死总人数的67.68%。（3）青年TOAST病因分型所占比由高至低依次为：小动脉闭塞型（SAD）34例（34.34%）、大动脉粥样硬化型（LAA）27例（27.27%）、心源性栓塞型（CE）21例（21.21%）、其他明确病因型（SOE）12例（12.12%）和不明原因型（SUE）5例（5.05%）。（4）不同青年脑梗死分型中血清hsCRP、IL-1以及IL-6水平增高程度，LAA型中各指标增高程度明显高于其它亚型（P＜0.05）。（5）青年脑梗死最常见的独立危险因素依次是：高脂血症（52.53%）、高Hcy血症（49.49%）、高血压（46.46%）、糖尿病（27.27%）、吸烟（21.21%）以及饮酒（20.20%）。结论：（1）青年脑梗死最常见的TOAST分型是小动脉闭塞型（SAD）、大动脉粥样硬化型（LAA）及心源性栓塞型（CE）。（2）炎症反应在大动脉粥样硬化型（LAA）青年脑梗死的发病中起了一定的作用。（3）高血压、糖尿病、高脂血症、高Hcy、吸烟、饮酒是青年脑梗死的重要独立危险因素。
[Abstract]:Objective: young cerebral infarction refers to cerebral infarction between 18 and 45 years old. By observing 99 young patients with acute cerebral infarction, the main risk factors and characteristics of young cerebral infarction were discussed in order to achieve early intervention, early detection and early prevention. The purpose of reducing morbidity and disability rates. Methods: a total of 99 patients with acute cerebral infarction aged 18-45 years from October 2011 to October 2013 in our department of neurology were analyzed. All of them were confirmed by CT or MRI in our hospital. The etiology and risk factors of young cerebral infarction were analyzed by TOAST etiological classification. Results:. 1) the incidence rate of young cerebral infarction was 4.38% of all the patients with cerebral infarction in the same period. The sex ratio of young men and women was 2: 1. The incidence rate of young cerebral infarction was also related to population distribution, work pressure and so on. 2) with the increase of age, the incidence of cerebral infarction in young people increased obviously, and the number of young people aged 36 to 45 years old accounted for 67.68% of the total number of young cerebral infarction. (3) the proportion of etiological classification of young TOAST from high to low was as follows: 34 cases of arteriolar occlusive type, 27 cases of large artery atherosclerosis, 21 cases of cardiogenic embolism and 21 cases of cardiac embolism, 12 cases of other definite etiology type, and 5 cases of unexplained type of TOAST, and 5 cases of unexplained type, 5 cases and 5.05%, respectively, of the etiological classification of TOAST in young patients were as follows: 34 cases of arteriolar occlusive type, 27 cases of large artery atherosclerotic type, 21 cases of cardiac embolism type, 12 cases of other definite etiology type, and 5 cases of unknown cause type, respectively. (4) the levels of serum hsCRPP-IL-1 and IL-6 in different young patients with cerebral infarction were significantly higher than those in other subtypes (P < 0.05). (5) the most common independent risk factors for young cerebral infarction were: hyperlipidemia 52.53, hyperlipidemia 49.49, hypertension 46.46, diabetes 27.27m, smoking 21.21) and drinking 20.20%. Conclusion:. The most common TOAST classification of cerebral infarction in young patients was arteriolar occlusive type (SAD), arteriosclerotic type (LAA) and cardiogenic embolization type (CEE). Inflammatory reaction plays a role in the pathogenesis of cerebral infarction in young patients with atherosclerotic arteriosclerosis. 3) Hypertension, diabetes, hyperlipidemia, hyperHcy, smoking and drinking are important independent risk factors for cerebral infarction in young people.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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