韩国修订缺血性脑卒中TOAST分型研究  

The research on the Korean modified TOAST classification in patients with ischemic stroke

作　　者：陈小灵 罗丹阳[2] 刘伟[2,3] 黄燕 柳华 CHEN Xiao-ling;LUO Dan-yang;LIU Wei;HUANG Yan;LIU Hua(Department of Neurology,1.Yanting County People's Hospital,Yanting 621600;Second Clinical College of North Sichuan Medical College & Nanchong Central Hospital,Nanchong 637000;Nanbu County People's Hospital,Nanbu 637300;The Third People's Hospital of Chengdu,Medical College of Southwest Jiaotong University,Chengdu 610031,Sichuan,China)

机构地区：[1]盐亭县人民医院神经内科,四川盐亭621600 [2]川北医学院第二临床学院·南充市中心医院神经内科,四川南充637000 [3]南部县人民医院神经内科,四川南部637300 [4]西南交通大学医学院·成都市第三人民医院神经内科,四川成都610031

出　　处：《川北医学院学报》2019年第5期504-507,共4页Journal of North Sichuan Medical College

基　　金：四川省科技厅项目(2015JY0122)

摘　　要：目的:探讨韩国修订TOAST分型在川东北地区缺血性脑卒中(ischemic stroke,IS)患者中的应用。方法:连续纳入因急性IS住院治疗的患者732例,根据韩国改良TOAST分型标准(KmTOAST)对每个患者分型,并和传统TOAST分型对比,分析不同分型标准下的各亚型分布情况,并分析不同亚型的危险因素。结果:和传统TOAST分型标准比较,KmTOAST分型动脉粥样硬化血栓形成(大血管梗死,LAA或AT)亚型所占比例更大(65.6%/41.4%),不明原因病变型(SUD)更少(43.7%/17.1%)。在危险因素分析中,KmTOAST分型中AT亚型血脂异常比心源性栓塞(CE)亚型更为常见(AT/CE:76.3%vs.60.9%,P=0.003)。和传统TOAST分型比较,KmTOAST分型中AT亚型患高血压和血脂异常更少(高血压:66.9%/75.6%,P=0.009;血脂异常:76.3%/86.1%,P=0.001);吸烟在AT、小血管病变(SAD)亚型中更少(AT:36.7%/58.1%,P=0.001;SAD:46.7%/87.5%,P=0.007),而在SUD中更多(37.6%/14.7%,P=0.001);饮酒在AT和SUD亚型中更少(AT:26.5%/40.3%,P=0.001;SUD:22.4%/35.3%,P=0.009)。结论:韩国改良TOAST分型在中国人群中具有临床实用和可操作性,对IS准确病因分型有益,有利于加强IS防治。Objective:To study the application of Korean modified TOAST classification(KmTOAST)in ischemic stroke(IS)patients in Northeast Sichuan.Methods:The clinical data was collected from 732 cases of acute IS patients consecutively.According to the improved TOAST classification standard of Korea(KmTOAST),each patient was classified and compared with the traditional TOAST classification.The characteristics of the IS subtypes from the two different classifications were analyzed,meanwhile,we also performed an analyses on the risk factors for different subtypes.Results:Compared with traditional TOAST,the proportion of the atherosclerotic stroke(LAA/AT)subtype was higher(65.6%/41.4%),however,the number of stroke of undetermined etiology(SUD)was lower(43.7%/17.1%).For risk factors analyses,the dyslipidemia was more common in AT than in cardiac embolism(CE)under KmTOAST criteria(AT/CE:76.3%vs.60.9%,P=0.003).Compared with traditional TOAST criteria,the proportion of hypertension and dyslipidemia in KmTOAST classification was lower(hypertension:66.9%/75.6%,P=0.009;dyslipidemia:76.3%/86.1%,P=0.001),and smoking was lower in AT and small-artery disease(SAD)subtypes(AT:36.7%/58.1%,P=0.000;SAD:46.7%/87.5%,P=0.007)and was more in SUD(37.6%/14.7%,P=0.001);as for drinking,the number was smaller in AT and SUD(AT:26.5%/40.3%,P=0.001;SUD:22.4%/35.3%,P=0.009).Conclusion:The KmTOAST criteria for IS is clinically practicable and operable.It is favorable for accurate classification of IS and conducive to strengthening the prevention and treatment of IS.

关 键 词：缺血性脑卒中 IS TOAST 危险因素 韩国修订TOAST 

分 类 号：R743[医药卫生—神经病学与精神病学]