中青年进展性脑卒中患者病因分型及危险因素分析  

Clinical analysis of risk factors and TOAST criteria in young and middle-aged adults for progressive stroke

作　　者：张平[1] 朱斌[1] 闫海清[1] 贵永堃[1] 牛晓露[1] 李彤[1] 

机构地区：[1]新乡医学院第一附属医院神经内科,河南453100

出　　处：《脑与神经疾病杂志》2014年第3期184-187,共4页Journal of Brain and Nervous Diseases

基　　金：河南省卫生厅科技攻关项目(2011020094)

摘　　要：目的：分析中青年进展性脑卒中患者的危险因素。方法根据病情，将同时期29～60岁急性缺血性脑卒中患者140例，为低分子肝素急性卒中试验（ TOAST）分型大、小血管病变型，分为进展性卒中组70例，即研究组；完全性卒中患者70例，即对照组。比较研究组和对照组的一般资料、生物化学指标及头颅影像学的不同。结果高血压病史、嗜酒史、入院时所测收缩压、大血管病变、低密度脂蛋白、超敏C反应蛋白（hs-CRP）及同型半胱氨酸（Hcy）浓度两组间比较差异有统计学意义（P＜0．05，P＜0．01）；多元逐步回归分析发现血清Hcy浓度、hs-CRP浓度及LDL正相关。结论中青年患者进展性卒中的危险因素为高血压病史、嗜酒史、大血管病变、LDL、发病时收缩压、血清hs-CRP 和血清Hcy。血清Hcy浓度升高可能为中青年进展性卒中患者的独立危险因素。Objective To analysis risk factors for patients in young and middle-aged with progressive stroke （PS）.Methods 140 patients （aged 29~60years） with acute ischemic strok were classified into large-artery atherosclerosis and small-vessel occlusion based on TOAST .Divide patients with acute ischemic stroke at the same stage into research group （ 70 patients with PS ） and control group （ 70 patients with completed ischemic stroke ） according to the progression of patients .Compare to seek differences between the two groups via statistical analysis of physical data , biochemical indexes and head images .Results There are statistically significant differences in history of hypertension , alcoholism , increases of systolic blood pressure upon admission , macro vascular diseases , low density lipoprotein （ LDL ） concentrations of high-sensitive C-reactive protein （ hs-CRP ） and serum homocysteine （Hcy） between the two groups （P〈0.01 or P〈0.05）.Multiple stepwise regression analysis showed the concentration of serum Hcy was positively related with LDL and the concentration of hs-CRP .Conclusion Risk factors of patients with PS include history of hypertension , alcoholism, large-artery atherosclerosis , LDL and the increases of systolic blood pressure , concentration of hs-CRP and serum Hcy when the disease attacking .The increase of serum Hcy is a possible independent risk factor of young and middle-aged patients with PS .

关 键 词：进展性卒中 危险因素 同型半胱氨酸 TOAST分型 

分 类 号：R743.32[医药卫生—神经病学与精神病学]