青年女性脑梗死患者常见危险因素及其对发病年龄的影响  

Common risk factors and its impact on the age of onset in young female patients with cerebral infarction

作　　者：周涌涛[1] 肖蓉[2] 张新卿[1] 郭秀海[1] 陈彪[1] 贾建平[1] 

机构地区：[1]首都医科大学宣武医院神经内科,北京100053 [2]首都医科大学宣武医院病案室,北京100053

出　　处：《中国脑血管病杂志》2012年第2期62-66,共5页Chinese Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金资助项目(30970926)

摘　　要：目的探讨青年女性脑梗死患者常见的危险因素及其对发病年龄的影响。方法回顾性分析2000年11月1日—2010年10月31日,在首都医科大学宣武医院住院的260例青年女性新发脑梗死患者的临床资料,观察青年女性脑梗死的常见危险因素,采用Logrank时序检验分析各危险因素对发病年龄的影响。结果①260例患者中,36～45岁患者最多(65.8%),18～25岁患者最少(11.5%)。最常见的危险因素是高血压(39.2%)、糖尿病(14.6%)、高脂血症(8.1%);其次是卵圆孔未闭(4.2%)、烟雾病(3.8%)、高同型半胱氨酸血症(3.5%)、血管炎(3.5%)及心房颤动(3.5%)等;高血压的发生率随着年龄的增长而上升(χ2=17.573,P<0.01),卵圆孔未闭的发生率随着年龄增长而降低(χ2=12.666,P<0.01)。②TOAST分型:原因不明性型占31.2%(81/260);大动脉粥样硬化型占26.9%(70/260);小动脉闭塞型和其他病因明确型,分别占16.5%(43/260)、15.0%(39/260);心源性栓塞型占10.4%(27/260)。③Logrank时序检验分析,并未发现有高血压、糖尿病、高脂血症及心房颤动患者的卒中发病年龄低于平均年龄;而患有房间隔缺损、卵圆孔未闭、血管炎的患者,发生脑梗死时的年龄[中位数年龄(95%CI)],分别为26(13～39)、29(19～39)、35(33～37)岁,低于该组的平均年龄[39(38～40)岁],均P<0.05。结论青年女性脑梗死患者最常见的危险因素是高血压病、糖尿病、高脂血症,烟雾病、卵圆孔未闭,同型半胱氨酸血症及血管炎亦占有较高的比例;其中患有房间隔缺损、卵圆孔未闭、血管炎者,发生脑梗死的年龄较小。Objective To investigate the common risk factors,clinical features and the impact of risk factors on the age of onset in young female patients with cerebral infarction.Methods The clinical data of 260 young female patients with new cerebral infarction were analyzed retrospectively.The common risk factors and the impact of risk factors on the age of onset in young women with cerebral infarction were observed.Results ①Among the 260 patients,36-45 years were the majority（65.8%） and 18-25 years were the minority（11.5%）.Their most common risk factors were hypertension（39.2%）,diabetes mellitus（14.6%） and hyperlipidemia（8.1%）;followed by other risk factors,such as moyamoya disease（3.8%）,patent foramen ovale（4.2%）,hyperhomocysteinemia（3.5%）,vasculitis（3.5%） and atrial fibrillation（3.5%）.The incidence of hypertension increased with age（χ2=17.573,P0.01）,and patent foramen ovale decreased with age（χ2=12.666,P0.01）.②The TOAST criteria：cryptogenic type accounted for 31.2%（81/260）;large-artery atherosclerotic type accounted for 26.9%（70/260）;small-artery occlusion and other definitive cause types accounted for 16.5%（43/260） and 15.0%（39/260） respectively;and cardioembolic type accounted for 10.4%（27/260）.③Logrank test analysis did not find that the age of stroke onset in patients with hypertension,diabetes,hyperlipidemia and atrial fibrillation was lower than the mean age;and the age（median age [95% CI]） of the occurrence of cerebral infarction in patients with atrial septal defect,patent foramen ovale and vasculitis were 26（range 13-39）,29（range 19-39）,and 35（range 33-37） years,respectively.They were lower than the average age of this group [39 years range 38-40],all P0.05）.Conclusion The most common risk factors in young female patients with cerebral infarction are hypertension,diabetes,hyperlipidemia,moyamoya disease,and patent foramen ovale.Hyperhomocysteinemia and vasculitis also have a higher proportion.Among the patients with

关 键 词：脑梗死 危险因素 青年 女性 发病年龄 

分 类 号：R743.33[医药卫生—神经病学与精神病学]