青年人脑梗死与脑出血患者的病因、危险因素及预后:293例对比分析  

Etiological factor, risk factor and prognosis in young patients with cerebral infarction and cerebral hemorrhage:comparative analysis among 293 cases

作　　者：沙瑞娟[1] 张宙[1] 余天浩[1] 袁慧琳[1] 

机构地区：[1]南京医科大学附属南京脑科医院ICU,江苏省南京市210029

出　　处：《中国临床康复》2004年第31期6838-6839,6845,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:为进一步认识和防治青年脑卒中,对比分析青年人脑梗死和脑出血的病因、危险因素及预后。方法:回顾性分析147例青年脑梗死和146例青年脑出血患者临床资料。结果:147例脑梗死患者有明确病因者133例(90.5%),病因不明者14例(9.5%),其中动脉粥样硬化84例(57.1%)、炎症性血管病20例(13.6%)、凝血机制障碍7例(4.8%)、先天性血管畸形7例(4.8%)、心源性栓塞4例(2.7%)、偏头痛诱发2例(1.4%)。147例中经治疗痊愈114例(77.6%),显著进步27例(18.4%),死亡6例(4.1%)。146例脑出血患者有明确病因者115例(78.8%),病因不明者31例(21.2%),其中先天性血管畸形57例(39.0%),动脉粥样硬化52例(35.6%),烟雾病4例(2.7%),脑静脉血栓形成引发脑出血2例(1.4%)。146例中经治疗痊愈106例(72.6%),显著进步19例(13.0%),死亡21例(14.4%)。结论:动脉粥样硬化是青年人脑卒中最常见的病因,血管炎及先天性血管畸形分别为脑梗死、脑出血患者另一常见病因。主要危险因素是高血压、吸烟、高脂血症。一般预后好,治愈率高,致残率低。脑出血的死亡率明显高于脑梗死。AIM:To compare and analyze the etiological factor,risk factor and prognosis in young patients with cerebral infarction(CI) and cerebral hemorrhage(CH) for further realization,prevention and treatment of stroke in the youth. METHODS:Clinical information of 147 young patients with CI and 146 young patients with CH was analyzed retrospectively. RESULTS:Among 147 young patients with CI, there were 133 patients(90.5%) with categorical etiological factor and 14 patients(9.5%) with ill-defined etiological factor, including 84 patients(57.1%) with atherosclerosis,20 patients(13.6%) with inflammatory angiopathy,7 patients(4.8%) with disorder of blood coagulation mechanism,7 patients(4.8%) with congenital vascular malformation,4 patients(2.7%) with cardiac embolism,2 patients(1.4%) with migraine provocation,114 patients(77.6%) with full recovery after treatment,27 patients(18.4%) with marked progress and 6 patients(4.1%) with death.Among 146 young patients with CH,there were 115 patients(78.8%) with categorical etiological factor and 31 patients(21.2%) with ill-defined etiological factor, including 57 patients(39.0%) with congenital vascular malformation,52 patients (35.6%) with atherosclerosis,4 patients(2.7%) with moyamoya disease,2 patients(1.4%) with CH induced by the thrombosis of cerebral veins,106 patients(72.6%) with full recovery after treatment,19 patients(13.0%) with marked progress and 21 patients(14.4%) with death. CONCLUSION:Atherosclerosis is the most commonly etiological factor of young people with stroke,vasculitis and congenital vascular malformation are another commonly etiological factors of patients with CI and CH respectively.The mainly risk factors are hypertension,smoking and hyperlipidemia.Generally speaking,the prognosis is good,the curing rate high,and the disability rate low.The death rate of CH is remarkably higher than that of CI.

关 键 词：脑出血 脑梗死 患者 危险因素 青年人 先天性血管畸形 治疗 结论 一般 人脑 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R544.1[医药卫生—临床医学]