青年脑梗死TOAST分型及危险因素分析  

Analysis of the Causes and Risk Factors of Ischemic Stroke in Youth by TOAST Criteria

作　　者：林鑫江[1] 杜登青[1] 庄伟端[1] 

机构地区：[1]汕头大学医学院第一附属医院神经内科,广东省汕头市515041

出　　处：《中华全科医学》2012年第5期686-688,共3页Chinese Journal of General Practice

摘　　要：目的探讨青年脑梗死的病因及临床特点。方法采用回顾性分析方法连续性登记2009年1月-2011年12月入院的72例青年脑梗死患者(年龄≤45),按照TOAST标准进行病因分型,分析临床资料,分析病因,确定其所属分型,并统计学分析其主要危险因素。结果本组TOAST各亚型构成比如下:①心源性栓塞型19.4%(14/72);②大动脉粥样硬化型13.9%(10/72);③小动脉闭塞型26.4(19/72);④其他明确病因型12.5%(9/22);⑤不明原因型27.8%(20/72),且高发年龄段在36～45岁年龄段72.2%(52/72),危险因素最高的是高血压占41.7%(30/72),血脂异常占34.7%(25/72),糖尿病占18.1%(13/72),吸烟占15.3%(11/72),饮酒占9.7%(7/72),TOAST分型的组间危险因素单因素分析示:高血压(70%,χ2=11.82,P<0.05)在小动脉闭塞型中显著升高,而血脂异常在其他明确原因分型中显著升高(77.8%,χ2=9.50,P<0.05)。结论该地区青年脑梗死的病因分型以不明原因和小动脉闭塞型及心源性栓塞型所占比例高,且在36～45岁年龄段发病较高,应加强这个年龄段的诊治,危险因素以高血压及血脂异常明显,高血压在小动脉闭塞型中明显,而血脂异常在其他明确原因分型明显,为针对不同青年脑梗死亚型在诊治上有所侧重提供指导。Objective To explore the causes and risk factors of ischemic stroke in young adults.Methods According to the Trial of Org10172 in Acute Stroke Treatment（TOAST） criteria,72 young patients（≤45 years old） were included in this study.Data about causes and risk factors of ischemic stroke were collected and analyzed prospectively from consecutive stroke inpatients in the First Affiliated Hospital of Medical College of Shantou University from Jan.2009 to Dec.2011.Results The proportion of ischemic stroke subtypes according to TOAST criteria was as follows： stroke of cardioembolism（CE） 19.4%,large-artery atherosclerosis（LAA） 13.9%,small-vessel occlusion（SAO） 26.4%,stroke of other determined etiology（OD） 12.5%,stroke of undetermined etiology（UND） 27.8%.The highest exposure ratios of risk factors were hypertension（41.7%）,blood lipid abnormality（34.7%）,diabetes（18.1%）,smoking（15.3%）,alcohol consumption（9.7%）.Univariate analysis of the risk factors between the stroke subgroups showed that hypertension（70%,χ2=11.82,P0.05） increased significantly in SAO subtype.Blood lipid abnormality（77.8%,χ2=9.50,P0.05） increased significantly in OD subtype.Conclusion The UND and CE and LAA subtypes were the most common etiological types in young adults,especially in more than 35 years old.The exposure ratios of risk factors were the highest in hypertension and lipid abnormality.The study may provide an instruction for prevention and treatment different subtype in ischemic stroke for young adults.

关 键 词：脑梗死 青年 TOAST分型法 病因 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]