18~50岁青年卒中患者危险因素特征及中医证候分型的横断面研究  

A cross-sectional study on risk factors and TCM syndromes in stroke patients aged 18-50

作　　者：徐寒莹 张影[2] 张冬梅[2] 徐鹏[2] 吕志国[2] 李鹏飞 杨秀璐 王健[2] XU Hanying;ZHANG Ying;ZHANG Dongmei;XU Peng;LV Zhiguo;LI Pengfei;YANG Xiulu;WANG Jian(School of Chinese Medicine,Changchun University of Chinese Medicine,Changchun 130117,China;Encephalopathy Center,Affiliated Hospital of Changchun University of Chinese Medicine,Changchun 130021,China)

机构地区：[1]长春中医药大学中医学院,长春130117 [2]长春中医药大学附属医院脑病中心,长春130021

出　　处：《吉林中医药》2023年第7期793-798,共6页Jilin Journal of Chinese Medicine

基　　金：国家重点研发计划项目(2019YFC1709902);国家自然科学基金面上项目(8207152160);国家中医药管理局中医药循证能力建设项目(2019XZZX-NB005);吉林省科技发展计划项目(20190905005SF)。

摘　　要：目的收集青年卒中患者临床资料,分析危险因素及中医证候分布特点,以进一步指导青年卒中早期预防。方法对长春市内2所三级甲等医院的464例青年卒中患者临床资料进行回顾性分析。464名患者分为缺血性卒中组与出血性卒中组,分析2组患者的性别比、危险因素、入院时NIHSS水平。分析青年卒中患者危险因素与中医证候分型的关联。结果本研究共纳入病例464例(缺血组394例,出血组70例),2组在血脂异常、高血压、吸烟方面差异显著(P<0.05);出血组入院时NIHSS评分显著高于缺血组(P<0.05);高血压、低高密度脂蛋白胆固醇血症、心脏病、颈动脉硬化与TOAST分型关联显著(P<0.05);在165例具备中医证型的患者中,缺血组频率最高证型为风痰阻络证72例(51.8%),出血组频率最高证型为肝阳暴亢、风火上扰证12例(46.2%);缺血组中血脂异常、饮酒与中医证型关联显著(P<0.05);出血组在高同型半胱氨酸血症方面与中医证型关联显著(P<0.05)。结论青年应注重预防早发动脉硬化及相关危险因素。高三酰甘油血症在青年卒中发病中作用凸显,建议制定个性化调脂方案进行预防。青年卒中的中医证型分布主要集中在风、痰、火3个病因要素为主的证型,青年可在未病时进行针对性中医特色预防。Objective To collect the clinical data of young stroke patients,analyze the risk factors and the distribution characteristics of TCM syndromes,so as to further guide the early prevention of stroke in the young adults.Methods A retrospective analysis was conducted on the clinical data of 464 young stroke patients from 2 tertiary hospitals in Changchun City.They were divided into an ischemic stroke group and a hemorrhagic stroke group.Their sex ratios,risk factors and NIHSS levels at admission were analyzed.The correlation between risk factors and TCM syndrome classifications in them was analyzed.Results A total of 464 cases were included in this study(394 cases in the ischemic group and 70 cases in the hemorrhagic group).There were significant differences in dyslipidemia,hypertension and smoking between the two groups(P<0.05).The NIHSS score of the hemorrhagic group at admission was significantly higher than that of the ischemic group(P<0.05).Hypertension,LDL-C,heart disease,carotid atherosclerosis were significantly associated with the TOAST classifications(P<0.05).Among the 165 patients with TCM syndromes,the ischemic group had the highest frequency of wind-phlegm obstructing collaterals in 72 cases(51.8%),while the hemorrhagic group had the highest frequency of hyperactivity of liver yang and disturbance of wind-fire in 12 cases(46.2%).In the ischemic group,dyslipidemia and drinking were significantly associated with the TCM syndromes(P<0.05).There was a significant correlation between hyperhomocysteinemia and TCM syndromes in the hemorrhagic group(P<0.05).Conclusion Young adults should pay attention to the prevention of early-onset arteriosclerosis and its related risk factors.Hypertriglyceridemia plays a prominent role in the onset of stroke in them,and it is recommended to develop personalized lipid-lowering plans for its prevention.The distributions of TCM syndromes in the young stroke patients are mainly concentrated in the three pathogenic factors of wind,phlegm and fire,and young adults can receive a t

关 键 词：青年 卒中 临床特征 动脉硬化 病因 

分 类 号：R255.2[医药卫生—中医内科学]