青年缺血性脑卒中类肝素药物治疗急性缺血性脑卒中试验分型与中国缺血性卒中亚型分型比较  

Comparison between trial of org 10172 in acute stroke treatment and Chinese ischemic stroke subclassification classification in young patients with cerebral ischemic stroke

作　　者：郭升[1] 殷闯[2] 苏祯磊 魏园园[1] 谭军[2] 

机构地区：[1]新乡医学院第三临床学院,河南新乡453003 [2]新乡医学院第三附属医院神经内科,河南新乡453003

出　　处：《新乡医学院学报》2017年第3期194-196,共3页Journal of Xinxiang Medical University

基　　金：新乡市重点科技攻关计划资助项目(编号:ZG13021)

摘　　要：目的比较类肝素药物治疗急性缺血性脑卒中试验(TOAST)分型和中国缺血性卒中亚型(CISS)分型在青年缺血性脑卒中患者中的应用价值。方法选取2014年3月至2016年6月新乡医学院第三附属医院收治的首发青年缺血性脑卒中患者148例,根据患者的临床症状、影像学特点及相关辅助检查结果,分别由2位神经内科医师进行TOAST分型和CISS分型,并对2种分型方法的结果进行比较。结果 148例患者的TOAST分型病因学亚型依次为:大动脉粥样硬化型(LAA)58例(39.19%)、小动脉闭塞型(SAA)53例(35.81%)、其他明确病因型(SOE)18例(12.16%)、原因不明的卒中(SUE)11例(7.43%)、心源性栓塞型(CE)8例(5.41%);CISS分型病因学亚型依次为:LAA75例(50.68%)、穿支动脉疾病型(PAD)35例(23.65%)、其他明确病因型(OE)29例(19.60%)、心源性卒中型(CS)6例(4.05%)、原因不明的卒中(UE)3例(2.03%)。CISS分型中LAA比例显著高于TOAST分型中LAA的比例,TOAST分型中SAA和SUE比例显著高于CISS分型中PAD和UE比例,差异均有统计学意义(P<0.05)。CISS分型中CS和OE比例与TOAST分型中CE和SOE比例比较差异无统计学意义(P>0.05)。结论大动脉粥样硬化是青年缺血性卒中的重要原因;相对于TOAST分型,CISS分型在指导对青年缺血性脑卒中的临床诊断与治疗更具有优势。Objective To compare the application value of trial of org 10172 in acute stroke treatment（ TOAST） and Chinese ischemic stroke subclassification（ CISS） classification in young patients with cerebral ischemic stroke. Methods A total of 148 young patients with cerebral ischemic stroke were collected from March 2014 to June 2016 in the Third Affiliated Hospital of Xinxiang Medical University. The patients were performed with TOAST and CISS classification by two neurologists respectively according to clinical symptoms,imaging features and relevant auxiliary examinations. The results of the two classifications were compared. Results The etiological subtypes of TOAST classification in 148 patients were large artery atherosclerosis（ LAA） in 58 cases（ 39. 19%）,small-artery occlusion lacunar（ SAA） in 53 cases（ 35. 81%）,stroke of other demonstrated etiology（ SOE） in 18 cases（ 12. 16%）,stroke of other undemonstrated etiology（ SUE） in 11 cases（ 7. 43%）,and cardio embolism（ CE） in 8 cases（ 5. 41%） in turn. The etiological subtypes of CISS classification in 148 patients were LAA in 75 cases（ 50. 68%）,penetrating artery disease（ PAD） in 35 cases（ 23. 65%）,other etiologies（ OE） in 29 cases（ 19. 60%）,cardiogenic stroke（ CS） in 6 cases（ 4. 05%）,and undetermined etiology（ UE） in 3 cases（ 2. 03%） in turn. The proportion of LAA in CISS classification was significantly higher than that in TOAST classification（ P 〈0. 05）; and the proportions of SAA and SUE in TOAST classification were significantly higher than those of PAD and UE in CISS classification（ P 〈 0. 05）. There was no significant difference between the proportions of CS and OE in CISS classification and the proportions of CE and SOE in TOAST classification（ P 〉 0. 05）. Conclusions Large artery atherosclerosis is the important cause in young patients with cerebral ischemic stroke. CISS classification has more advantages than TOAST classification in guiding clinical diagnosis

关 键 词：类肝素药物治疗急性缺血性脑卒中试验分型 中国缺血性卒中亚型分型 缺血性脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]