青年缺血性卒中脑血管病变特点及危险因素研究  

Characteristics of cerebrovascular and risk in factors young ischemic stroke

作　　者：范清雨[1] 王虎清[1] 张桂莲[1] 展淑琴[1] 吴海琴[1] 

机构地区：[1]西安交通大学医学院第二附属医院神经内科,陕西西安710004

出　　处：《中国医药导报》2015年第32期66-68,73,共4页China Medical Herald

基　　金：国家自然科学基金面上项目(81270415)

摘　　要：目的探讨青年缺血性卒中患者脑血管病变特点,分析其可能的危险因素。方法选择西安交通大学第二附属医院神经内科2011年1月~2014年12月收治的发病时间≤2周并行脑血管造影（DSA）检查的青年缺血性卒中患者157例,分为DSA正常组和脑动脉狭窄组,并选择同期参加体检的年龄匹配的126例正常人作为正常对照组。分析本组青年缺血性卒中患者脑血管病变特点以及可能导致青年缺血性卒中患者脑动脉狭窄的危险因素。结果 DSA检查结果：DSA正常63例,脑血管狭窄94例,脑血管狭窄患者中单纯颅内动脉狭窄52例,单纯颅外动脉狭窄25例,颅内外血管均有狭窄17例;单纯前循环狭窄62例,其中单纯大脑中动脉狭窄33例,单纯后循环狭窄13例,前后循环均有狭窄19例。DSA正常组、脑动脉狭窄组的高血压、吸烟、高同型半胱氨酸血症、血脂异常、糖尿病、饮酒、颈动脉斑块比例大于正常对照组,差异有统计学意义（P〈0.05）;但各危险因素在DSA正常组、脑动脉狭窄组之间差异无统计学意义（P〉0.05）。结论青年缺血性卒中患者脑动脉狭窄特点：以单纯颅内动脉狭窄为主,前循环为主,单纯大脑中动脉狭窄发生率高;传统动脉硬化的危险因素是青年患者发生缺血性卒中的危险因素,但不能完全解释青年卒中患者的脑动脉狭窄中,提示青年卒中患者发生动脉狭窄可能还有其他危险因素。Objective To explore the characteristics of cerebrovascular in young patients with ischemic stroke and analyze the possible risk factors. Methods From June 2014 to December 2014, in Department of Neurology, the Second Affiliated Hospital, Medical College of Xi＇an Jiaotong University, 157 young stroke patients who completed DSA within two weeks after stroke were selected, according to the DSA findings, they were divided into cerebral artery stenosis group（94 cases） and normal DSA group（63 cases）, at the same time, 126 physical examination persons in the same age were selected as normal control group. the characteristics of cerebrovascular in young patients with ischemic stroke,risk factors of cerebral arterial stenosis in young patients with ischemic stroke were analyzed. Results The results of DSA： 63 cases had normal DSA, 94 cases had cerebral artery stenosis, among cerebral artery stenosis, 52 cases had pure intracranial arterial stenosis, 25 cases had pure extracranial artery stenosis, 17 cases had intra and extra cranial stenosis; 62 cases had anterior circulation stenosis, in them 33 cases had pure middle cerebral artery stenosis, 13 cases had posterior circulation stenosis, 19 cases had anterior and posterior circulation stenosis. The constituent ratios of hypertension, smoking, high homocysteine, blood lipid abnormality, diabetes, alcohol consumption and carotid artery plaque in normal DSA group and cerebral artery stenosis group were higher than those in normal control group, the differences were statistically significant（P〈0.05）; but these in normal DSA group and cerebral artery stenosis group were compared, the differences were not statistically significant（P〉0.05）. Conclusion Most young ischemic stroke patients have cerebral artery stenosis, these stenosises are located in intracranial and anterior circulation artery mainly, especially in middle cerebral artery; the traditional atherosclerosis risk factors are related to the occurrence of ischemic stroke in young patients, but i

关 键 词：青年卒中 脑血管狭窄 动脉硬化 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]