老年颅内动脉粥样硬化性狭窄致缺血性脑卒中患者危险因素分析  

Risk factors for ischemic stroke in elderly patients with intracranial atherosclerotic stenosis

作　　者：王炎强[1] 孙绍洋 张炳俊[1] 戴永强[1] 伍爱民[1] 鲍健[1] 胡学强[1] 陆正齐[1] 

机构地区：[1]中山大学附属第三医院神经内科,广州510630 [2]青岛大学医学院附属医院神经内科

出　　处：《中华老年心脑血管病杂志》2015年第5期459-462,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年颅内动脉粥样硬化性狭窄致缺血性脑卒中患者危险因素的分析。方法选择颅内动脉粥样硬化性狭窄致缺血性脑卒中患者235例,根据年龄分为45-64岁组99例,65-74岁组84例,75-99岁组52例。比较3组各颅内动脉粥样硬化性狭窄致缺血性脑卒中危险因素分布的差异。结果45-64岁组、65-74岁和75-99岁组患者吸烟（37.4%、25.0%和13.5%）、饮酒（20.2%、7.1%和3.8%）、血脂异常（8.1%、11.9%和30.8%）、同型半胱氨酸[（14.64±6.42）μmol/L、（16.75±6.78）μmol/L和（18.02±9.56）μmol/L]、糖化血红蛋白[（7.12±2.13）%、（6.56±2.04）%和（6.57±1.50）%]、脂蛋白（a）[（239.77±207.20）mg/L、（228.71±211.03）mg/L和（183.68±126.46）mg/L]、TG/HDL-C（2.04±1.62、1.64±0.98和2.16±1.82）、TC/HDL-C（4.40±1.09、4.89±1.36和4.99±1.76）比较,差异有统计学意义（P〈0.05,P〈0.01）。45-64岁组、65-74岁组以单支血管受累多见,75-99岁以多支血管受累多见,3组患者均以前后循环、大脑中动脉、大脑后动脉受累多见。结论良好的生活习惯能延缓颅内动脉粥样硬化性狭窄致缺血性脑卒中的发生,同型半胱氨酸与脂代谢紊乱是老年颅内动脉粥样硬化性狭窄致缺血性脑卒中患者的主要危险因素。Objective To study the risk factors for ischemic stroke in elderly patients with intracranial atherosclerotic stenosis（ICAS）.Methods Two hundred and thirty-five elderly ischemic stroke patients with ICAS were divided into 45-64 years old group（n=99）,65-74 years old group（n=84）and 75-99 years old group（n=52）.The distribution of risk factors for ischemic strok in 3groups was compared.Results The proportion of smokers and alchol drinkers,the incidence of hyperlipidemia,and the serum levels of Hcy,HbAlc and Lp（a）,the TG/HDL-C and TC/HDL-C ratios differd significantly in mild,moderate and severe AIS groups（37.4%vs 25.0%vs13.5%,20.2%vs 7.1%vs 3.8%,8.1% vs 11.9% vs 30.8%,14.64±6.42μmol/L vs 16.75±6.78μmol/L vs 18.02±9.56μmol/L,7.12%±2.13% vs6.56%±2.04% vs6.57%±1.50%,239.77±207.20 mg/L vs 228.71±211.03 mg/L vs 183.68±126.46 mg/L,2.04±1.62 vs1.64±0.98 vs 2.16±1.82,4.40±1.09 vs 4.89±1.36 vs 4.99±1.76,P〈0.05,P〈0.01）.Conclusion Healthy life style can delay the occurrence of ischemic stroke in elderly ICAS patients.Hcy and lipid metabolism disorders are the major risk factors for ischemic stroke.

关 键 词：动脉粥样硬化 颅内动脉疾病 卒中 吸烟 高脂血症 高半胱氨酸 脂蛋白(A) 

分 类 号：R743.3[医药卫生—神经病学与精神病学]