青年缺血性卒中的CT血管造影特点及病因筛查分析  

CT angiography characteristics and etiological screening analysis of ischemic stroke in young people

作　　者：车红英 张伟生 杨伟斌[3] Che Hongying;Zhang Weisheng;Yang Weibin(Department of Radiology,Huzhou Nanxun District Traditional Chinese Medicine Hospital,Huzhou 313009,China;Department of Neurology,Huzhou Nanxun District Hospital of Traditional Chinese Medicine,Huzhou 313009,China;Department of Radiology,Lishui Central Hospital,Lishui 323000,China)

机构地区：[1]湖州市南浔区中医院放射科,湖州313009 [2]湖州市南浔区中医院神经内科,湖州313009 [3]丽水市中心医院放射科,丽水323000

出　　处：《中国医师进修杂志》2023年第12期1140-1144,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨青年缺血性卒中(IS)的CT血管造影(CTA)特点及病因筛查。方法回顾性选取2019年1月至2021年12月湖州市南浔区中医院和丽水市中心医院收治的青年(17~35岁)IS患者61例(观察组),观察患者脑部CTA的特点。选择同期同年龄段的青年体检者136例(对照组),采用单因素分析和多因素Logistic回归分析筛选影响青年IS发病的危险因素。结果61例患者CTA检查结果显示,患者梗死部位常见于基底核区[50.82%(31/61)]及脑叶[39.34%(24/61)];病灶多呈现为多发[60.66%(37/61)],病变血管多为前循环动脉[67.21%(41/61)],以颈内动脉病变多见[47.54%(29/61)],后循环动脉病变则以椎-基底动脉病变多见[29.51%(18/61)]。多因素Logistic回归分析结果显示,高血压、糖尿病、卒中家族史、吸烟、酗酒、血脂异常和血清同型半胱氨酸>6μmol/L是青年IS发病的独立危险因素(P<0.05)。结论青年IS患者常见基底核区及脑叶梗死,病灶多发,颈内动脉病变、椎-基底动脉病变多见;高血压、糖尿病、卒中家族史、吸烟、酗酒、血脂异常以及高同型半胱氨酸血症是青年IS发病的危险因素。Objective To investigate the CT angiography(CTA)characteristics and etiological screening of ischemic stroke(IS)in young adults.Methods A total of 61 young IS patients(17-35 years old)admitted to Huzhou Nanxun District Traditional Chinese Medicine Hospital and Lishui Central Hospital from January 2019 to December 2021 were selected as the observation group,and the characteristics of brain CTA were observed.One hundred and thirty-six cases of young medical examiners of the same age were selected as the control group.The general clinical data of the two groups of subjects were recorded.Univariate analysis and multivariate Logistic regression were used to analyze the related factors affecting the incidence of patients in the observation group.Results The results of CTA examination of 61 patients showed that the infarcts of the patients were usually located in the basal ganglia in 50.82%(31/61),and in the lobe of the brain in 39.34%(24/61),and the lesions were mostly multiple in 60.66%(37/61).Most of the diseased vessels were anterior circulation arteries in 67.21%(41/61),internal carotid artery disease was more common in 47.54%(29/61),and vertebrobasilar artery disease was more common in posterior circulation in 29.51%(18/61).The results of multivariate Logistic analysis showed that hypertension,diabetes,family history of stroke,smoking,alcoholism,dyslipidemia and serum homocysteine>6μmol/L were independent influencing factors of the incidence of young IS patients(P<0.05).Conclusions In young IS patients,infarcts in the basal ganglia and cerebral lobes are common,with multiple lesions,internal carotid artery lesions and vertebrobasilar artery lesions are more common.The incidence of this disease is multi-factorial,and the incidence is higher in young people with hypertension,diabetes,family history of stroke,smoking,alcoholism,dyslipidemia and hyperhomocysteinemia.

关 键 词：脑梗塞 年轻成人 危险因素 CT血管造影 

分 类 号：R743.3[医药卫生—神经病学与精神病学]