不同TOAST病因分型中青年脑卒中患者发病危险因素与认知损害特点分析  

Analysis of risk factors and cognitive impairment characteristics of stroke in young and middle-aged stroke patients with different TOAST etiology classification

作　　者：王喜 崔小丽[1] 高俊卿[1] 宋迪 尹毅丹 孙宁[1] WANG Xi;CUI Xiao-li;GAO Jun-qing(Department of Neurology,Shaanxi Provincial People's Hospital,Xi'an Shaanxi 710068,China)

机构地区：[1]陕西省人民医院神经内科,陕西西安710068

出　　处：《临床和实验医学杂志》2023年第18期1922-1925,共4页Journal of Clinical and Experimental Medicine

基　　金：陕西省自然科学基础研究计划项目(编号:2021JQ-903)。

摘　　要：目的探讨不同TOAST病因分型中青年脑卒中患者发病危险因素与认知损害特点。方法回顾性选取2020年2月至2023年2月陕西省人民医院收治的100例中青年脑卒中患者作为研究对象,将其作为观察组。另选取同期来陕西省人民医院治疗的100例中老年脑卒中患者作为对照组。对比两组患者TOAST病因分型,并分析中青年脑卒中患者发病的影响因素;采用Logistic回归分析分析中青年脑卒中发病的独立危险因素。随后将观察组患者依照不同TOAST病因进行分型,其中大动脉粥样硬化(LAA)型42例,其他原因(OD)型26例,小动脉闭塞(SAO)型16例,不明原因(UD)型13例,心源性脑梗死(CE)型3例。对比不同TOAST病因分型患者认知障碍发生率,并应用蒙特利尔认知评估量表(MOCA)评分中患者的注意力、执行功能、记忆力、语言功能、视空间、抽象思维、计算力和定向力评分来评价患者认知损害的特点。结果两组患者TOAST病因分型中UD、CE、LAA分型比较,差异均无统计学意义(P>0.05),观察组OD分型发生率高于对照组,SAO分型发生率低于对照组,差异均有统计学意义(P<0.05)。观察组与对照组患者性别构成比、既往吸烟史、既往饮酒史、体重指数、高Hcy情况比较,差异均无统计学意义(P>0.05),观察组与对照组患者脑卒中家族史、合并高血压、糖尿病、心脏病、高血脂相关基础疾病、动脉夹层、烟雾病情况比较,差异均有统计学意义(P<0.05)。Logistic回归分析结果表明:合并高血压、糖尿病、高血脂、动脉夹层、烟雾病为中青年脑卒中发病独立危险因素(P<0.05)。100例中青年脑卒中患者中认知障碍发生率为75.00%(75/100),其中LAA型为30.67%(23/75),SAO型为28.00%(21/75),CE型为17.33%(13/75),OD型为16.00%(12/75),UD型为8.00%(6/75)。不同TOAST病因分型患者认知障碍发生率比较,差异有统计学意义(P<0.05)。不同TOAST病因分型患者MOCA评分中执行能力�Objective To explore the risk factors and cognitive impairment characteristics of stroke in middle-aged and young stroke patients with different TOAST etiological subtypes.Methods One hundred middle-aged and young stroke patients admitted to Shaanxi Provincial People's Hospital from February 2020 to February 2023 were retrospectively selected as the research subjects and divided into the observation group.In addition,100 middle-aged and elderly stroke patients who came to Shaanxi Provincial People's Hospital for treatment during the same period were selected as the control group.The TOAST etiology classification of the two groups of patients was compared,and the influencing factors of stroke incidence in middle-aged and young patients were analyzed.Logistic regression analysis was used to analyze the independent risk factors of stroke incidence in middle-aged and young patients.Then the patients in the observation group were grouped according to different TOAST etiological types,including 42 cases of large atherosclerosis(LAA),26 cases of other reasons(OD),16 cases of small artery occlusion(SAO),13 cases of unknown cause(UD),and 3 cases of cardiogenic cerebral infarction(CE).And the incidence of cognitive impairment in patients with different TOAST etiological subtypes was compared.The characteristics of cognitive impairment in patients were evaluated using the Montreal Cognitive Assessment(MOCA)scores for attention,executive function,memory,language function,visual space,abstract thinking,computational power,and directional ability.Results There was no significant difference in the UD,CE,and LAA subtypes of TOAST between the two groups of patients(P>0.05).The incidence of OD subtypes in the observation group was higher than that in the control group,while the incidence of SAO subtypes was lower than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences between the observation group and the control group in terms of gender,previous smoking history,p

关 键 词：TOAST病因分型 中青年 脑卒中 认知损害 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]