轻型卒中的病因分型和相关危险因素分析

发布时间：2019-01-28 20:40

【摘要】：目的分析中国广东地区不同病因轻型卒中患者的相关危险因素。方法发病3 d内的轻型卒中(minor stroke,MS)患者,根据CISS分型分为大动脉粥样硬化型(large artery atherosclerosis,LAA)、心源性卒中(cardiogenic stroke,CS)、穿支动脉病(penetrating artery disease,PAD)、其他病因(other etiology,OE)及病因未明(undetermined etiology,UE)五个亚组,分析它们之间危险因素的差异。结果共纳入轻型卒中患者303例,在常见危险因素中,轻型卒中患者患有高血压、高脂血症及糖尿病所占比例相对最多,分别为72.3%、58.3%及39.9%;而不同病因中,LAA及PAD所占比例最高(分别为41.9%、50.8%),且两组患者对比血甘油三酯(TG)(1.765±1.18)mg/L vs.(2.19±1.84)mg/L,P=0.03]、载脂蛋白B(Apo B)[(0.95±0.29)mg/L vs.(1.11±0.46)mg/L,P=0.009]、C反应蛋白(CRP)[(6.63±11.30)mg/L vs.(3.42±5.02)mg/L,P=0.042]及Apo B/Apo A1[(0.754±0.25)mg/L vs.(0.875±0.49)mg/L,P=0.019]的差异均有统计学意义。结论高血压、高脂血症及糖尿病是轻型卒中最主要的危险因素;广东地区轻型卒中发病机制最常见为PAD,其次为LAA;对轻型卒中患者进行TG、Apo B、Apo B/Apo A1、CRP等检测,也许能协助进行CISS分型。
[Abstract]:Objective to analyze the risk factors of mild stroke patients with different etiology in Guangdong, China. Methods patients with mild stroke (minor stroke,MS) within 3 days of onset were divided into four groups according to CISS classification: large atherosclerotic (large artery atherosclerosis,LAA, cardiogenic stroke (cardiogenic stroke,CS), perforating artery disease (penetrating artery disease,PAD), and other etiological factors (other etiology,. OE) and five subgroups of unknown etiology (undetermined etiology,UE) were analyzed for their differences in risk factors. Results 303 patients with mild stroke were included. Among the common risk factors, hypertension, hyperlipidemia and diabetes were the most common risk factors, which were 72.3% and 39.9%, respectively. The proportion of LAA and PAD was the highest in different etiology (41.9%, 50.8%), and the serum triglyceride (TG) (1.765 卤1.18) mg/L vs. (2.19 卤1.84) mg/L,P=0.03 was compared between the two groups. Apolipoprotein B (Apo B) [(0.95 卤0.29) mg/L vs. (1.11 卤0.46) mg/L,P=0.009], C-reactive protein (CRP) [(6.63 卤11.30) mg/L vs. (3.42 卤5.02) mg/L,] There were significant differences between Apo B/Apo A1 [(0.754 卤0.25) mg/L vs.] and Apo B/Apo A1 [(0.875 卤0.49) mg/L,P=0.019]. Conclusion Hypertension, hyperlipidemia and diabetes mellitus are the main risk factors for mild stroke, and PAD, is the second most common risk factor for mild stroke in Guangdong area. The detection of TG,Apo, Apo B/Apo A _ 1 and CRP in patients with mild stroke may be helpful for CISS typing.
【作者单位】：中山大学附属第三医院神经内科;中山大学孙逸仙纪念医院神经内科;中山市人民医院(中山大学附属中山医院);中山大学附属第五医院神经内科;北京大学深圳医院神经内科;
【基金】：广东省医学科学技术研究基金项目(项目编号:B2016142) 中山市科技计划项目,社会发展攻关计划(医疗)(编号:2016B1024)
【分类号】：R743.3

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