高龄脑梗死TOAST各型预后和影响因素分析  

Prognosis and risk factors of elderly patients with ischemic stroke classified by TOAST classification

作　　者：尚文锦[1] 郭海强 陈红兵[1] 周晓明[1] 杨世亮[1] 洪华[1] 

机构地区：[1]中山大学附属第一医院神经科,广州510080 [2]广东省汕头市潮阳区大峰医院神经科,515100

出　　处：《广东医学》2013年第7期1024-1028,共5页Guangdong Medical Journal

摘　　要：目的探讨高龄脑梗死患者不同病因分型复发和病死率差异及影响各型复发和死亡的因素。方法回顾性收集170例入住神经科且年龄≥80岁的脑梗死患者。病因分型采用TOAST分型标准,纳入分析的基线变量包括年龄、性别、临床表现、既往史、脑白质病变、牛顿郡社区卒中计划(OCSP)分型和治疗措施。在2012年10月进行电话随访。结果高龄脑梗死患者TOAST各型复发率差异无统计学意义(P=0.551),而心源性栓塞和原因未明组累计病死率明显高于大动脉粥样硬化和小动脉闭塞组(P<0.01)。影响各型复发和死亡的因素不同。结论高龄脑梗死患者不同病因分型的复发率无明显差异,各型病死率及影响各型复发和死亡的因素存在明显差异。Objective To determine the difference in recurrence, survival and risk factors among different etiologic classifications of ischemic stroke in elderly Chinese. Methods A total of 170 patients over 80 years with ischemic stroke admitted to the department of neurology were enrolled for retrospective analysis. The cause of ischemic stroke was classified according to the TOAST criteria. Patients were followed up in October 2010 by telephone interviews. Age, sex, clinic features, past history, leukoaraiosis, OCSP subtypes and treatments were used for analysis. Results Ischemic stroke subtype according to the TOAST criteria was not a significant predictor for recurrence （P = 0. 551 ）, whereas it was a significant predictor of survival （P 〈 0. 001 ）. Patients in the cardioembolism and undetermined etiology subgroups suggested significantly higher mortality than those with small - artery occlusion and large - artery atherosclerosis subgroups. The risk factors of recurrence and survival in each subgroup were different. Conclusion There is no difference of recurrence across etiologic subtypes of ischemic stroke, whereas survival and risk factors of recurrence and survival in each subtype are different.

关 键 词：高龄 脑梗死 病因分型 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]