青年脑梗死患者病情严重程度与其危险因素及病因的关系

被引：37

作者：

付联群

王晓丽

闵连秋

李芳

机构：

[1] 辽宁医学院附属第一医院神经内科

来源：

广东医学 | 2015年 / 36卷 / 01期

关键词：

青年脑梗死; 危险因素; 病因; 病情严重程度; 复发;

D O I：

10.13820/j.cnki.gdyx.2015.01.032

中图分类号：

R743.3 [急性脑血管疾病（中风）];

学科分类号：

摘要：

目的调查青年脑梗死患者发病与复发的危险因素及病因,评估青年脑梗死患者病情严重程度与发病危险因素及病因的关系。方法回顾性分析2006—2013年来自中国北方三级医院的脑梗死数据。18～45岁的脑梗死患者共1 395例被纳入研究,临床评估包括完整的神经系统检查及NIHSS评分,诊断依据病史、生化、影像学及心脏检查,病因诊断按TOAST进行分类。同一患者因脑梗死住院2次及以上视为复发。应用Spearman等级相关分析评价NIHSS与发病危险因素高血压、糖尿病及TOAST亚型的相关性,应用logistic回归分析评价青年脑梗死复发的危险因素。结果 (1)18～45岁的脑梗死患者共1 395例,年龄(38.50±6.318)岁,其中男1 104例(79.1%)。(2)发病危险因素中,发病率较高的有高血压(44.4%)、家族史(39.2%)、脂代谢异常(16.8%)、糖尿病(13.8%)、吸烟(47.1%)、饮酒(41.6%),以上因素更多见于男性,心瓣膜病、心房颤动及头痛史更多见于女性。(3)TOAST分类:大动脉粥样硬化型596例(42.7%),心源性90例(6.5%),小血管病变225例(16.1%),其他明确病因71例(5.1%),多个潜在病因168例(12.1%),病因未明204例(14.6%),资料缺失41例(2.9%);(4)NIHSS严重程度:轻度1 066例(76.4%),中度293例(21.0%),重度22例(1.6%),资料缺失14例(1.0%);(5)NIHSS与糖尿病(P=0.208)、高血压(P=0.869)的相关性不显著,NIHSS与TOAST分类的相关性不显著(P=0.955);(6)心房颤动是青年脑梗死患者复发的危险因素(OR=3.842,95%CI 1.039～14.203,P=0.044)。结论青年脑梗死发病男性多见,发病危险因素以传统血管危险因素为主,大、小血管病变、多个病因共存及心源性卒中是其常见病因;入院时病情严重程度以轻度为主,入院时病情严重程度与发病危险因素高血压及糖尿病不相关,与病因亚型TOAST分类不相关;预防青年脑梗死复发尤其应注意心源性病因的筛查及防治。

引用

页码：116 / 120

页数：5

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