青年脑梗死的影像学特点TOAST分型及危险因素分析  

The imaging characteristics,TOAST types and risk factors in youth cerebral infarction

作　　者：温清[1] 刘人恺[1] 杨春水[1] 

机构地区：[1]广东医学院附属南山医院神经内科,深圳518052

出　　处：《中国实用神经疾病杂志》2015年第14期9-11,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的观察青年脑梗死TOAST分型分布、致病危险因素及CT／MRI特征。方法选取青年脑梗死患者392例为研究对象，完善各项辅助检查，分析患者临床资料。根据TOAST分型对患者进行分型，分析青年脑梗死患者影像学特征及危险因素。结果（1）根据TOAST分型：大动脉粥样硬化型（LAA）47例，心源性栓塞型（cE）16例，小动脉闭塞型（SAO）91例，其他病因型（OD）39例，不明原因型（UND）199例。与18～34岁年龄段比较，35～45岁年龄段患者小动脉闭塞型（SA0）比例更高（P〈0．05）。（2）392例患者重要危险因素包括高血压、高脂血症、糖尿病、心脏病、高同型半胱氨酸血症、高尿酸血症、吸烟及嗜酒。其中高血压比较最高（60．2％）。与18～34岁年龄段比较，35～45岁年龄段患者高脂血症比例更高（P〈0．05）。（3）影像学检查显示基底节脑梗死218例，脑叶脑梗死106例，小脑脑梗死29例，脑干脑梗死30例，多发性脑梗死169例，腔隙性脑梗死93例。经脑血管造影检查57例，6例存在烟雾病。结论青年脑梗死具有一定的临床及影像学特征，高血压、高脂血症为其最常见的危险因素。Objective To observe the imaging characteristics, TOAST types and risk factors in youth cerebral infarc- tion. Methods 392 cases with cerebral infarction in young patients were selected as the research objects, and then the clinical data of the patients were collected when consummating each auxiliary examination. All patients were classified into different types according to the TOAST, then imaging characteristics and risk factors were analyzed in youth cerebral infarction. Results According to TOAST subtypes： there were 47 cases with large artery atherosclerosis （LAA） ; 16 cases with cardiogenic em- bolism type （CE） ; 91 cases with small artery occlusion （SAO） ; 39 cases with other causes （OD） ; 199 cases with unknown type （UND）. Compared with the age of 18~34 years, patients in the age of 35~45 years had higher ratio of small artery oc- clusion （SAO） （P〈0.05）. The important risk factors of 392 patients included hypertension, hyperlipidemia, diabetes, heart disease, high homocysteine, hyperuricemia, smoking and drinking. Hypertension occupied the highest ratio of 60.20/oo. Com- pared with the age of 18~34 years, patients in the age of 35~45 years had higher ratio of hyperlipidemia （P〈0.05）. Imaging examination showed that there were 218 cases with basal ganglia infarction, 106 patients with lobar cerebral infarction, 29 cases with cerebellar infarction, 30 patients with brainstem infarction, 169 cases with multiple cerebral infarction, 93 patients with lacunar infarction, 6 patients with moyamoya disease by cerebral angiography examination in 57 cases. Conclusion Young a- dults with cerebral infarction have clinical and imaging characteristics. Hypertension and hyperlipidemia are the most common risk factors.

关 键 词：脑梗死 青年 TOAST分型 影像学 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]