青年人脑梗死危险因素分析及与 TOAST 分型的相关性研究  

Analysis of risk factors of cerebral infarction in young adults and its correlation with TOAST types

作　　者：陈彩云 麻春玲 唐静 

机构地区：[1]河北省滦南县医院神经内科,063500

出　　处：《中国基层医药》2017年第4期582-585,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨青年人脑梗死的危险因素及其与临床 TOAST 分型的相关性。方法收集首发急性青年脑梗死患者（年龄18～45岁）82例，分析青年脑梗死患者的危险因素，及 TOAST 分型各亚型的比例与危险因素的相关性。结果青年脑梗死的危险因素依次为：高脂血症（χ2＝48．703，P ＜0．05）、高血压（χ2＝40.829，P ＜0．05）、颈动脉硬化（χ2＝46．217，P ＜0．05）、高同型半胱氨酸血症（χ2＝40．255，P ＜0．05）、吸烟史（χ2＝7．853，P ＜0．05）、糖尿病（χ2＝18．256，P ＜0．05）、家族史（χ2＝5．944，P ＜0．05）、心脏病（χ2＝5．754， P ＜0．05）；其 TOAST 分型各亚型所占比由高至低为：小动脉闭塞型（SAD）（39．0％），大动脉粥样硬化型（LAA）（24．4％），原因不明的脑梗死（SUE）（17．0％），其他原因所致脑梗死（SOE）（12．2％），心源性脑栓塞型（CE）（7．3％）；LAA 亚型的主要危险因素为高脂血症、高血压、颈动脉硬化；SUE 亚型的主要危险因素为高同型半胱氨酸血症；SOE 亚型的主要危险因素为高血压、糖尿病；CE 亚型的主要危险因素为心脏病。结论青年脑梗死组以小动脉闭塞型所占比例最高，高脂血症、高血压、颈动脉硬化、心脏病、糖尿病、高同型半胱氨酸血症、肥胖、吸烟及家族史为青年人脑梗死主要的危险因素，应积极干预。Objective To explore the risk factors of youth cerebral infarction and its correlation with clinical TOAST types.Methods 82 young patients with acute cerebral infarction（aged from 18 to 45 years old）were select-ed.The risk factors for youth cerebral infarction patients,and the proportion of TOAST subtype and related risk factors were analyzed.Results Risk factors for youth cerebral infarction were as follows：hyperlipidemia （χ2 =48.703,P 〈0.05）,hypertension （χ2 =40.829,P 〈0.05）,carotid sclerosis （χ2 =46.217,P 〈0.05）,hyperhomocysteinemia （χ2 =40.255,P 〈0.05）,smoking history （χ2 =7.853,P 〈0.05）,diabetes （χ2 =18.256,P 〈0.05）and family history （χ2 =5.944,P 〈0.05）,heart disease （χ2 =5.754,P 〈0.05）.The proportion of their TOAST subtypes were as following：small artery occlusion lacunar（SAD）（39.0%）,large artery atherosclerosis（LAA）（24.4%）,stroke of other undetemined etiology（SUE）（17.0%）,and acute stroke of other detemined etiology（SOE）（12.2%）,cardio-embolism（CE）type（7.3%）.Major risk factors for LAA subtype included hyperlipidemia,hypertension and carotid atherosclerosis;Major risk factor for SUE subtype was hyperhomocysteinemia;Major risk factors for SOE included hypertension,diabetes.Major risk factor for CE subtype was heart disease.Conclusion The highest proportion of TOAST types in youth cerebral infarction group is small artery occlusion lacunar.Major risk factors for this group of youth cerebral infarction are as follows：hypertension,carotid atherosclerosis,heart disease,diabetes,hyperhomocys-teinemia,obesity,smoking and family history,and these risk factors should be actively intervened.

关 键 词：脑梗死 青年人 TOAST 分型 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]