青年缺血性卒中患者脑动脉狭窄的分布特点及病因分析

被引：28

作者：

宋晓微

薛素芳

李潇颖

刘晨昱

武剑

机构：

[1] 首都医科大学宣武医院神经内科

来源：

中国脑血管病杂志 | 2014年 / 03期

关键词：

卒中; 脑缺血; 脑动脉; 狭窄; 青年; 中年;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）];

学科分类号：

1002 ;

摘要：

目的探讨青年缺血性卒中患者脑动脉狭窄的发生率、分布特点及可能的病因。方法回顾性纳入217例发病≤2周的缺血性卒中患者,分为青年组(18～45岁,106例)及中年组(46～55岁,111例)。比较青年组与中年组脑动脉狭窄的发生率及分布情况,并对伴有脑动脉狭窄患者的危险因素及病因进行分析。结果 (1)青年组脑动脉狭窄的发生率为69.8%(74/106),中年组为78.4%(87/111),差异无统计学意义(P>0.05)。(2)青年组与中年组脑动脉狭窄在颅、内外分布差异无统计学意义,均以颅内动脉狭窄为主[分别为75.7%(56/74)和62.1%(54/87)]。青年组前循环狭窄发生率为71.6%(53/74),高于中年组的41.4%(36/87);中年组前、后循环均有狭窄的发生率为20.7%(18/87),高于青年组的8.1%(6/74),P均<0.05。青年组单纯大脑中动脉狭窄发生率为58.9%(33/56),高于中年组的27.8%(15/54),P<0.05;中年组椎动脉及基底动脉狭窄发生率为27.8%(15/54),高于青年组的12.5%(7/56),P<0.05。(3)中年组脑动脉狭窄患者中,高血压、糖尿病、冠心病及饮酒者所占的比例高于青年组,P<0.01或P<0.05。中年组动脉粥样硬化性狭窄发生率高于青年组[93.1%(81/87)对比64.9%(48/74),P<0.01],青年组不明原因的血管狭窄比例高于中年组[23.0%(17/74)对比2.3%(2/87),P<0.01]。非动脉粥样硬化病因中,青年组动脉夹层、烟雾病及血管炎发病率更高,但差异无统计学意义。结论青、中年卒中患者脑动脉狭窄发生率相近;青年卒中脑动脉狭窄以前循环为主,单纯大脑中动脉狭窄发生率高;动脉粥样硬化性狭窄的相关危险因素较少,而不明原因比例较高。

引用

页码：142 / 147

页数：6

共 13 条

[1] Traditional Risk Factors Are Not Major Contributors to the Variance in Carotid Intima-Media Thickness [J].

Rundek, Tatjana ;

Blanton, Susan H. ;

Bartels, Susanne ;

Dong, Chuanhui ;

Raval, Ami ;

Demmer, Ryan T. ;

Cabral, Digna ;

Elkind, Mitchell S. V. ;

Sacco, Ralph L. ;

Desvarieux, Moise .

STROKE, 2013, 44 (08) :2101-2108

[2]

Genetic Variant RNF213 c.14576G>A in Various Phenotypes of Intracranial Major Artery Stenosis/Occlusion[J] . Satoru Miyawaki,Hideaki Imai,Masahiro Shimizu,Shinichi Yagi,Hideaki Ono,Akitake Mukasa,Hirofumi Nakatomi,Tsuneo Shimizu,Nobuhito Saito.Stroke . 2013 (10)

[3]

Premature atherosclerosis: A major contributor to early-onset ischemic stroke[J] . Steven J. Kittner,Aneesh B. Singhal.Neurology . 2013 (14)

[4] Prevalence of stenoses and occlusions of brain-supplying arteries in young stroke patients [J].

von Sarnowski, Bettina ;

Schminke, Ulf ;

Tatlisumak, Turgut ;

Putaala, Jukka ;

Grittner, Ulrike ;

Kaps, Manfred ;

Tobin, William O. ;

Kinsella, Justin A. ;

McCabe, Dominick J. H. ;

Hennerici, Michael G. ;

Fazekas, Franz ;

Norrving, Bo ;

Kessler, Christof ;

Rolfs, Arndt .

NEUROLOGY, 2013, 80 (14) :1287-1294

[5] Lifestyle Risk Factors for Ischemic Stroke and Transient Ischemic Attack in Young Adults in the Stroke in Young Fabry Patients Study [J].

von Sarnowski, Bettina ;

Putaala, Jukka ;

Grittner, Ulrike ;

Gaertner, Beate ;

Schminke, Ulf ;

Curtze, Sami ;

Huber, Roman ;

Tanislav, Christian ;

Lichy, Christoph ;

Demarin, Vida ;

Basic-Kes, Vanja ;

Ringelstein, E. Bernd ;

Neumann-Haefelin, Tobias ;

Enzinger, Christian ;

Fazekas, Franz ;

Rothwell, Peter M. ;

Dichgans, Martin ;

Jungehulsing, Gerhard J. ;

Heuschmann, Peter U. ;

Kaps, Manfred ;

Norrving, Bo ;

Rolfs, Arndt ;

Kessler, Christof ;

Tatlisumak, Turgut .

STROKE, 2013, 44 (01) :119-U215

[6] Identification of a Genetic Variant Common to Moyamoya Disease and Intracranial Major Artery Stenosis/Occlusion [J].

Miyawaki, Satoru ;

Imai, Hideaki ;

Takayanagi, Shunsaku ;

Mukasa, Akitake ;

Nakatomi, Hirofumi ;

Saito, Nobuhito .

STROKE, 2012, 43 (12) :3371-+

[7]

Age at stroke: Temporal trends in stroke incidence in a large, biracial population[J] . Brett M. Kissela,Jane C. Khoury,Kathleen Alwell,Charles J. Moomaw,Daniel Woo,Opeolu Adeoye,Matthew L. Flaherty,Pooja Khatri,Simona Ferioli,Felipe De Los Rios La Rosa,Joseph P. Broderick,Dawn O. Kleindorfer.Neurology . 2012 (17)

[8]

Endovascular Stenting of Extracranial Carotid and Vertebral Artery Dissections: A Systematic Review of the Literature[J] . Martin H Pham,Rudy J Rahme,Omar Arnaout,Michael C Hurley,Richard A Bernstein,H Hunt Batjer,Bernard R Bendok.Neurosurgery . 2011 (4)

[9]

Spontaneous Dissection of the Carotid and Vertebral Arteries: the 10-year UCSD Experience[J] . Ankur Chandra,Ahmed Suliman,Niren Angle.Annals of Vascular Surgery . 2007 (2)

[10] Global burden of intracranial atherosclerosis [J].

Wong, Lawrence K. S. .

INTERNATIONAL JOURNAL OF STROKE, 2006, 1 (03) :158-159

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