不同TOAST亚型的青年脑梗死患者预后的差别及影响因素  

The differentiation of prognosis and potential influencing factors in juvenile cerebral infarction patients with different TOAST subtypes

作　　者：张艳丽[1] 

机构地区：[1]山东菏泽市立医院神经内科,菏泽274000

出　　处：《中国实用神经疾病杂志》2016年第16期20-22,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨不同TOAST亚型青年脑梗死患者预后差别和影响因素。方法对2012-01—2013-12我院收治的261例青年脑梗死患者(年龄≤45岁)的临床资料进行回顾性分析,按照TOAST标准进行病因分型,并根据随访记录,比较不同亚型患者复发率和病死率,找出不同TOAST亚型的预后影响因素。结果本组TOAST各亚型构成,心源性栓塞型(CE)40例(15.33%),大动脉粥样硬化型(LAA)90例(34.48%),小动脉闭塞型(SAO)47例(18.01%),其他明确病因型(ODC)32例(12.26%),不明原因型(UND)52例(19.92%);各亚型和病死率比较,差异有统计学意义(P<0.05),CE病死率最高;各亚型复发率比较,差异无统计学意义(P>0.05);血糖异常、吸烟、抗血小板凝聚治疗、NIHSS评分、饮酒、血脂异常是影响各亚型预后危险因素。结论不同TOAST亚型的青年脑梗死患者病死率有显著性差异,复发率差异不明显,预后影响因素各有特点,在临床诊断中应针对不同亚型有所侧重。Objective To investigate the differentiation of prognosis and potential influencing factors in juvenile cerebral infarction patients with different TOAST subtypes. Methods Clinical data containing 261 cases with juvenile cerehral infarction （45 years old or less）enrolled in our hospital from January 2012 to December 2013 were retrospectively analyzed. According to the TOAST criteria and follow-up records, we compared recurrence rate and mortality of different TOAST subtypes to find out potential factors affecting the prognosis. Results The constituent of TOAST subtypes showed that cardiogenic embolism （CE）occurred in 40 cases（15.33%）, atherosclerosis（LAA） in 90 cases（34.48%）, small artery occlusion（SAO） in 47 cases （18.01%）, other clear etiology（ODC） in 32 cases（12.26%） and unknown origin（UND） in 52 cases（19.92%）. Each subtype showed statistically significant differences in terms of mortality（P〈0.05） and CE subtype had the highest mortality rate; In addition, the recurrence rate presented no differences between each subtype（P〉0.05）; Finally, we found abnormal blood glu- cose, smoking, anti-platelet aggregation therapy, NIHSS scores, drinking, and serum lipid abnormalities were risk factors that affected prognosis of each subtype. Conclusion Juvenile cerebral infarction patients with different TOAST subtypes may have markedly different mortality and variable characteristics of prognosis but no obviously different recurrence rate, which should be emphasized for clinical diagnosis of different subtypes.

关 键 词：脑梗死 TOAST分型 预后 影响因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]