青年缺血性脑卒中的临床特点及危险因素分析  

Clinical characteristics and risk factors of ischemic stroke in young adults

作　　者：张丽敏[1] 史一凡 王丹[1] 孙越红[1] 李虓[1] 刘紫薇 许惠文 王冬至 张国军[1] Zhang Limin;Shi Yifan;Wang Dan;Sun Yuehong;Li Xiao;Liu Ziwei;Xu Huiwen;Wang Dongzhi;Zhang Guojun(Laboratory Diagnosis Center,Beijing Tiantan Hospital,Capital Medical University&Beijing Engineering Research Center of Immunological Reagents Clinical Research,Beijing100070,China)

机构地区：[1]首都医科大学附属北京天坛医院实验诊断中心,北京市免疫试剂临床工程技术研究中心,北京100070

出　　处：《中国综合临床》2022年第2期146-151,共6页Clinical Medicine of China

基　　金：北京天坛医院院青年科学基金(2016-YQN-09);首都医科大学科研培育基金(PYZ2017067)。

摘　　要：目的分析青年缺血性脑卒中患者的临床特点和危险因素。方法选择2019年3-10月北京天坛医院收治的年龄≤45岁80例卒中患者作为青年卒中组,采用回顾性病例对照研究,选取同期住院的年龄>45岁117例卒中患者作为中老年卒中组,对比两组患者间血液检测指标水平,并且纳入卒中相关危险因素,包括吸烟史、饮酒史、高血压、高血脂及糖尿病病史等进行比较分析。采用两组独立样本t检验、Mann-WhitneyU检验或χ^(2)检验比较两组患者的上述指标。结果中老年卒中组活化部分凝血活酶时间、蛋白S、尿酸、同型半胱氨酸及D二聚体分别为(29.73±3.40)s、(105.58±27.23)%、(297.29±85.99)μmol/L、(17.58±14.45)μmol/L及(2.75±3.08)mg/L,青年卒中组活化部分凝血活酶时间(31.51±6.75)s、蛋白S(115.20±26.97)%、尿酸(326.82±93.51)μmol/L、同型半胱氨酸(22.63±16.98)μmol/L、D二聚体(1.19±2.88)μg/mL,两组比较差异均有统计学意义(t值分别为2.17、2.01、2.20、2.14、2.13,P值分别为0.032、0.046、0.029、0.039、0.034)。青年卒中组狼疮抗凝物阳性率为12.5%(4/32),高于中老年卒中组的1.8%(1/57),两组比较差异有统计学意义(χ^(2)=4.46,P=0.035)。青年卒中组吸烟、饮酒比例分别为63.8%(51/80)、62.5%(50/80),均高于中老年卒中组的49.6%(58/117)、47.9%(56/117),两组比较差异均有统计学意义(χ^(2)值分别为3.86、4.09,P值分别为0.04、0.04);青年卒中组高血压、糖尿病比例分别为48.8%(39/80)、17.5%(14/80),均低于中老年卒中组的63.2%(74/117)、30.8%(36/117),两组比较差异均有统计学意义(χ^(2)值分别为4.08、4.56,P值分别为0.043、0.033)。根据尿酸及同型半胱氨酸水平将青年卒中划分为不同亚组并进行比较,高尿酸水平组(≥416μmol/L)患者肌酐水平高于正常尿酸水平组(<416μmol/L),分别为(90.08±28.46)mmol/L与(63.37±22.2)mmol/L,两组比较差异有统计学意义(t值为2.23,P值为0.046)。高同型Objective To analyze the clinical characteristics and risk factors of ischemic stroke in young adults.Methods A retrospective analysis was conducted on 80 ischemic stroke patients(age≤45 years)admitted to Beijing Tiantan Hospital from March 2019 to October 2019 as the young stroke group,and 117 ischemic stroke patients(age>45 years)hospitalized during the same period as the middle-aged and elderly stroke group.The blood test indexes of the two groups were compared,and the risk factors related to stroke,including smoking history,drinking history,hypertension,hyperlipidemia and diabetes history,were compared and analyzed.Two sets of independent sample t-test,Mann-Whitney U-test orχ²test were used to compare the above indicators of patients in the two groups.Results The activated partial prothrombin time,protein S,uric acid,homocysteine and D-dimer levels in middle-aged and elderly stroke group were(29.73±3.40)s,(105.58±27.23)%,(297.29±85.99)μmol/L,(17.58±14.45)μmol/L and(2.75±3.08)mg/L,respectively.Compared with the middle-aged and elderly stroke group,the young stroke group had higher activated partial thrombin time(31.51±6.75)s,protein S(115.20±26.97)%,uric acid(326.82±93.51)μmol/L,homocysteine(22.63±16.98)μmol/L and lower D dimer level of(1.19±2.88)mg/L compared with the elder group,the difference between the two groups was statistically significant(t values were 2.17,2.01,2.20,2.14 and 2.13,respectively,P values were 0.032,0.046,0.029,0.039 and 0.034,respectively).The positive rate of lupus anticoagulant in young stroke group was 12.5%(4/32),which was higher than 1.8%(1/57)in middle-aged and elderly stroke group,and there was significant difference between the two groups(χ^(2)=4.46,P=0.035).The proportions of smoking and drinking in young stroke group were 63.8%(51/80)and 62.5%(50/80),respectively,which were higher than 49.6%(58/117)and 47.9%(56/117)in middle-aged and elderly stroke group,and there was significant difference between the two groups(χ^(2) values were 3.86 and 4.09;P values wer

关 键 词：缺血性脑卒中 青年卒中 狼疮抗凝物 风险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]