中青年缺血性卒中脑动脉狭窄分布及危险因素分析

发布时间：2019-03-30 16:05

【摘要】：目的探讨中青年缺血性卒中患者脑动脉狭窄分布规律及相关危险因素。方法对50例青年缺血性卒中患者及68例中年患者行DSA检查,收集患者的临床资料,并进行比较。结果与青年组比较,中年组前循环血管狭窄率显著降低,后循环及联合病变率显著升高(P0.05~0.01)。青年组颅内血管狭窄率显著高于颅外及颅内-外联合病变率(均P0.01),中年组颅内-外联合病变显著高于颅内及颅外病变(均P0.05)。与青年组比较,中年组颅内血管狭窄率显著降低,颅外及颅内-外联合病变率显著升高(P0.05~0.01)。与青年组比较,中年组颅外动脉轻度狭窄的比率显著降低,中度狭窄及重度狭窄的比率显著增高(均P0.01)。与青年组比较,中年组颅内动脉轻度狭窄的比率显著降低,重度狭窄的比率显著增高(均P0.05)。与中年组比较,青年组高同型半胱氨酸血症比率显著增高(P0.01),糖尿病、冠心病、高血压比率显著降低(P0.05~0.01)。结论青年缺血性脑血管病的脑动脉狭窄以前循环病变为主,单纯大脑中动脉狭窄及高同型半胱氨酸血症发生率较高,伴发的动脉粥样硬化性疾病相对偏少。中年缺血性卒中患者后循环病变增多,串联及联合病变更多见,动脉狭窄程度更重,伴发的动脉粥样硬化性相关疾病更多。
[Abstract]:Objective to investigate the distribution and risk factors of cerebral artery stenosis in middle-aged and young patients with ischemic stroke. Methods DSA was performed in 50 young patients with ischemic stroke and 68 middle-aged patients. The clinical data of the patients were collected and compared. Results compared with the young group, the rate of anterior circulation stenosis in the middle-aged group decreased significantly, and the rate of posterior circulation and combined disease increased significantly (P 0.05 / 0.01). The rate of intracranial vascular stenosis in the young group was significantly higher than that in the extracranial and intracranial-extracranial combined lesions (P0.01), and the intracranial-extracranial lesions in the middle-aged group was significantly higher than that in the intracranial and extracranial lesions (P0.05). Compared with the young group, the rate of intracranial vascular stenosis in the middle-aged group was significantly lower than that in the young group, and the rate of extracranial and intracranial-extracranial combined lesions was significantly higher than that in the young group (P 0.05). The rate of mild stenosis of extracranial artery in middle-aged group was significantly lower than that in young group, while the ratio of moderate stenosis and severe stenosis was significantly higher in middle-aged group than that in young group (P0.01). Compared with the young group, the rate of mild stenosis of intracranial artery in middle-aged group was significantly lower and the rate of severe stenosis was significantly higher (P 0.05). The ratio of hyperhomocysteinemia in the young group was significantly higher than that in the middle-aged group (P0.01), and the rates of diabetes, coronary heart disease and hypertension were significantly lower in the young group than in the middle-aged group (P 0.05). Conclusion the incidence of cerebral artery stenosis and hyperhomocysteinemia in young patients with ischemic cerebrovascular disease is higher than that of middle cerebral artery stenosis and hyperhomocysteinemia, and the incidence of atherosclerotic diseases is relatively low. Middle-aged patients with ischemic stroke have more post-circulatory lesions, more tandem and combined lesions, more severe arterial stenosis, and more associated atherosclerosis-related diseases.
【作者单位】：解放军空军总医院神经内科;
【分类号】：R743.3

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