青年多发性脑梗死的危险因素、病因及预后分析
发布时间：2018-10-31 13:38
【摘要】：目的探讨青年多发性脑梗死患者的危险因素、病因及近期预后。 方法收集2011年9月至2013年7月在昆明医科大学第一附属医院神经内科住院的青年脑梗死患者71例,将患者分为单发性脑梗死(single cerebral infarction,SCI)组(29例)和多发性脑梗死(multiple cerebral infarction, MCI)组(42例),详细评估患者的血管病危险因素和病因,进行TOAST分型,采用NIHSS评分量表和改良Rankin量表对患者入院时的神经功能缺损程度及发病后3个月时的预后进行评定,根据资料类型选择χ2检验、t检验、秩和检验及Logistic回归分析比较两组患者在危险因素、病因和预后方面存在的差异。 结果研究的结果显示,青年脑梗死最常见的危险因素依次为男性性别[74.65%(53/71)]、高血压病[64.79%(46/71)]、吸烟[54.93%(39/71)]和高脂血症[49.30%(35/71)]。Logistic回归分析提示青年多发脑梗死的独立危险因素为高血压病(OR=3.48,95%CI1.52～7.97,P=0.01)和心脏疾病(OR=2.30,95%CI1.10-4.84,P=0.03)。从TOAST分型各亚型所占的比例来看,单发性脑梗死患者以大动脉病变卒中[44.83%(13/29)]、小动脉病变卒中[24.14%(7/29)]和心源性栓塞[13.79%(4/29)]为主,多发性脑梗死患者以大动脉病变卒中[30.95%(13/42)]、不明原因的卒中[26.19%(11/42)]和小动脉病变卒中[23.81%(10/42)]为主,两者差异明显(χ2=8.99,P0.05)。Logistic回归分析显示青年脑梗死患者预后不良的独立危险因素为病灶的数目(OR=23.4,95%CI1.44-379.47,P=0.03)和入院时的NIHSS评分(OR=5.44,95%CI2.19-13.51,P=0.01)。结论青年单发脑梗死与多发脑梗死在危险因素和病因方面存在差异,青年多发脑梗死的独立危险因素为高血压病和心脏疾病,病因以大动脉病变、不明原因和小动脉病变为主。影响青年脑梗死患者预后的独立危险因素为病灶的数目和入院时的NIHSS评分。
[Abstract]:Objective to investigate the risk factors, etiology and short-term prognosis of young patients with multiple cerebral infarction. Methods from September 2011 to July 2013, 71 young patients with cerebral infarction in Department of Neurology, first affiliated Hospital of Kunming Medical University were collected and divided into single cerebral infarction (single cerebral infarction,). SCI group (29 cases) and multiple cerebral infarction (multiple cerebral infarction, MCI) group (42 cases). The risk factors and etiology of vascular disease were evaluated in detail, and TOAST classification was performed. NIHSS score scale and modified Rankin scale were used to evaluate the degree of neurological deficit and prognosis at 3 months after onset. 蠂 2 test and t test were selected according to the data types. Rank sum test and Logistic regression analysis were used to compare the risk factors, etiology and prognosis between the two groups. Results the most common risk factors for cerebral infarction in young adults were male sex (74.65%) and hypertension (64.79% (46 / 71). Smoking [54.93% (39 / 71)] and hyperlipidemia [49.30% (35 / 71)]. Logistic regression analysis showed that the independent risk factor for multiple cerebral infarction was hypertension (OR=3.48,95%CI1.52~7.97,). P0.01) and heart disease (OR=2.30,95%CI1.10-4.84,P=0.03). According to the proportion of subtypes in TOAST classification, stroke in patients with single cerebral infarction was caused by arteriopathy [44.83% (13 / 29)]. Arteriopathy stroke [24.14% (7 / 29)] and cardiogenic embolism [13.79% (4 / 29)]. Patients with multiple cerebral infarction suffered from large artery disease stroke [30.95% (13 / 42)]. The incidence of stroke of unknown cause [26.19% (11 / 42)] and arteriopathy stroke [23.81% (10 / 42)] were significantly different (蠂 2: 8.99, P < 0.05). P0.05). Logistic regression analysis showed that the independent risk factors for poor prognosis in young patients with cerebral infarction were the number of lesions (OR=23.4,95%CI1.44-379.47,P=0.03) and the NIHSS score on admission (OR=5.44,95%CI2.19-13.51,). P0.01). Conclusion there are differences in risk factors and etiology between single cerebral infarction and multiple cerebral infarction in young people. The independent risk factors of multiple cerebral infarction in young people are hypertension and heart disease. The main causes are arteriopathy, unknown cause and arteriopathy. The independent risk factors influencing the prognosis of young patients with cerebral infarction were the number of lesions and the NIHSS score on admission.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3
本文编号：2302392
[Abstract]:Objective to investigate the risk factors, etiology and short-term prognosis of young patients with multiple cerebral infarction. Methods from September 2011 to July 2013, 71 young patients with cerebral infarction in Department of Neurology, first affiliated Hospital of Kunming Medical University were collected and divided into single cerebral infarction (single cerebral infarction,). SCI group (29 cases) and multiple cerebral infarction (multiple cerebral infarction, MCI) group (42 cases). The risk factors and etiology of vascular disease were evaluated in detail, and TOAST classification was performed. NIHSS score scale and modified Rankin scale were used to evaluate the degree of neurological deficit and prognosis at 3 months after onset. 蠂 2 test and t test were selected according to the data types. Rank sum test and Logistic regression analysis were used to compare the risk factors, etiology and prognosis between the two groups. Results the most common risk factors for cerebral infarction in young adults were male sex (74.65%) and hypertension (64.79% (46 / 71). Smoking [54.93% (39 / 71)] and hyperlipidemia [49.30% (35 / 71)]. Logistic regression analysis showed that the independent risk factor for multiple cerebral infarction was hypertension (OR=3.48,95%CI1.52~7.97,). P0.01) and heart disease (OR=2.30,95%CI1.10-4.84,P=0.03). According to the proportion of subtypes in TOAST classification, stroke in patients with single cerebral infarction was caused by arteriopathy [44.83% (13 / 29)]. Arteriopathy stroke [24.14% (7 / 29)] and cardiogenic embolism [13.79% (4 / 29)]. Patients with multiple cerebral infarction suffered from large artery disease stroke [30.95% (13 / 42)]. The incidence of stroke of unknown cause [26.19% (11 / 42)] and arteriopathy stroke [23.81% (10 / 42)] were significantly different (蠂 2: 8.99, P < 0.05). P0.05). Logistic regression analysis showed that the independent risk factors for poor prognosis in young patients with cerebral infarction were the number of lesions (OR=23.4,95%CI1.44-379.47,P=0.03) and the NIHSS score on admission (OR=5.44,95%CI2.19-13.51,). P0.01). Conclusion there are differences in risk factors and etiology between single cerebral infarction and multiple cerebral infarction in young people. The independent risk factors of multiple cerebral infarction in young people are hypertension and heart disease. The main causes are arteriopathy, unknown cause and arteriopathy. The independent risk factors influencing the prognosis of young patients with cerebral infarction were the number of lesions and the NIHSS score on admission.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3
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