缺血性卒中住院患者年龄特征与头颈部大动脉病变分布的多中心研究结果分析

发布时间：2018-04-10 17:33

本文选题：卒中 + 年龄　；参考：《中国脑血管病杂志》2017年06期

【摘要】：目的探讨不同年龄段缺血性脑血管病患者脑大动脉病变分布特点及危险因素的差异,为不同年龄段卒中的防治提供依据。方法连续性纳入2015年6月至2016年5月全国20家中心因短暂性脑缺血发作(TIA)与缺血性卒中住院患者共10 711例,从40岁起始,以每10岁为一年龄段将所有患者分为5个年龄段,比较不同年龄段间脑血管病危险因素差异。再将所有患者按性别分开,应用趋势卡方检验比较同一性别不同年龄段患者颅内、外及前、后循环大动脉狭窄的发生率和血管病变支数。结果 (1)老年患者危险因素以高血压、糖尿病、心房颤动居多(χ~2值分别为61.938、13.349、55.940,均P0.01);中青年吸烟史、脑血管病家族史及肥胖者居多(χ~2值分别为131.505、7.298、100.911,均P0.01)。(2)线性趋势卡方检验结果显示,随年龄增长,女性、男性颅外动脉病变中多支血管病变所占的比例均逐渐增加(χ~2值分别为54.799、161.370,均P0.01);女性患者颅内动脉多支血管病变所占比例逐渐下降(χ~2=5.328,P=0.021),而男性患者颅内动脉病变中多支血管狭窄所占的比例无明显变化趋势(χ~2=0.289,P=0.591)。(3)线性趋势卡方检验结果显示,随年龄增长,女性、男性单纯颅内动脉狭窄发生率均逐渐减少(χ~2=20.090;χ~2=42.351,均P0.01),单纯颅外动脉狭窄发生率均逐渐升高(χ~2=40.311;χ~2=90.698,均P0.01),颅内外动脉均存在狭窄的发生率逐渐升高(χ~2=12.077,P=0.001;χ~2=45.887,P0.01);女性单纯后循环血管狭窄发生率逐渐升高(χ~2=16.434,P0.01),男性单纯后循环血管狭窄发生率无变化趋势(χ~2=1.701,P=0.192),女性、男性前后循环动脉均狭窄的发生率逐渐升高(χ~2=4.587,P=0.032;χ~2=35.156,P0.01)。结论不同年龄段缺血性脑血管病患者动脉粥样硬化病变分布存在差异,不论女性还是男性,中青年患者主要为颅内动脉病变,老年患者主要为颅外动脉病变,女性老年患者存在后循环动脉病变较多。认识不同年龄段患者颅内动脉病变特征,将有助于针对不同年龄段人群制定个体化的卒中防治策略。
[Abstract]:Objective to explore the distribution characteristics and risk factors of cerebral arteriopathy in patients with ischemic cerebrovascular disease in different age groups, and to provide evidence for the prevention and treatment of stroke in different age groups.Methods from June 2015 to May 2016, a total of 10,711 inpatients with ischemic stroke were included in 20 centers in China due to transient ischemic attack (TIA). From the age of 40, all patients were divided into 5 age groups according to the age of every 10 years.To compare the risk factors of cerebrovascular disease in different age groups.Then all patients were separated by sex, and the incidence of intracranial, external, anterior and posterior arterial stenosis and the number of vessel lesion branches were compared by trend chi-square test in patients of different ages of the same sex.With age, women,There was no significant change trend in the proportion of vascular stenosis (蠂 ~ 2 / 28 ~ (9) P ~ (0.591N) 路L ~ (3)). The results of chi-square test showed that there was no significant change in the proportion of vascular stenosis.With age, women,The incidence rate increased gradually (蠂 2 + 16.434% P 0.01), but there was no change in the incidence of simple posterior circulation stenosis in male (蠂 2 / 1.701 / P = 0.192, female, P < 0.05).The incidence of stenosis of the anterior and posterior circulation arteries increased gradually in males (蠂 ~ 2 = 4.587), P ~ (0.032), 蠂 ~ (2 +) ~ (2) ~ (35.156) (P ~ (0.01)).Conclusion there are differences in the distribution of atherosclerotic lesions in patients with ischemic cerebrovascular diseases in different age groups, whether female or male, intracranial artery lesions in young and middle-aged patients, and extracranial artery lesions in elderly patients.The disease of posterior circulation artery is more common in female elderly patients.Understanding the characteristics of intracranial artery lesions in patients with different age groups will be helpful to formulate individualized stroke prevention and treatment strategies for different age groups.
【作者单位】：首都医科大学宣武医院血管超声科;吉林大学第一医院神经内科;苏州大学附属第一医院超声科;兰州大学第二医院超声科;天津市环湖医院超声科;大连市中心医院超声科;山西医科大学第一医院超声科;洛阳市中心医院神经内科;山东省聊城市人民医院脑科医院超声科;哈尔滨医科大学附属第一医院超声科;安徽省立医院超声科;中国医科大学附属第一医院超声科;包头市中心医院神经内科;福建省立医院超声科;绵阳市中心医院超声科;新疆医科大学第一附属医院超声科;广东省中医院超声科;昆明医科大学第二附属医院神经内科;珠海市人民医院超声科;湖南省脑科医院超声科;
【基金】：基金项目:国家卫生计生委脑卒中筛查与防治工程委员会[血管超声对短暂性脑缺血发作(TIA)与缺血性脑卒中住院患者颅内外动脉病变的多中心检查登记研究(201501)]
【分类号】：R445.1;R743.3

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