中青年进展性脑卒中患者病因分型及危险因素分析

目的分析中青年进展性脑卒中患者的危险因素。方法根据病情,将同时期29⁶0岁急性缺血性脑卒中患者140例,为低分子肝素急性卒中试验(TOAST)分型大、小血管病变型,分为进展性卒中组70例,即研究组;完全性卒中患者70例,即对照组。比较研究组和对照组的一般资料、生物化学指标及头颅影像学的不同。结果高血压病史、嗜酒史、入院时所测收缩压、大血管病变、低密度脂蛋白、超敏C反应蛋白(hs-CRP)及同型半胱氨酸(Hcy)浓度两组间比较差异有统计学意义(P<0.05,P<0.01);多元逐步回归分析发现血清Hcy浓度、hs-CRP浓度及LDL正相关。结论中青年患者进展性卒中的危险因素为高血压病史、嗜酒史、大血管病变、LDL、发病时收缩压、血清hs-CRP和血清Hcy。血清Hcy浓度升高可能为中青年进展性卒中患者的独立危险因素。

Clinical analysis fo risk factors and TOAST crite ria in young and middle-aged adults for progressive stroke

Objective To analysis risk factors for patients in young and middle-aged with progressive stroke （PS）.Methods 140 patients （aged 29~60years） with acute ischemic strok were classified into large-artery atherosclerosis and small-vessel occlusion based on TOAST .Divide patients with acute ischemic stroke at the same stage into research group （ 70 patients with PS ） and control group （ 70 patients with completed ischemic stroke ） according to the progression of patients .Compare to seek differences between the two groups via statistical analysis of physical data , biochemical indexes and head images .Results There are statistically significant differences in history of hypertension , alcoholism , increases of systolic blood pressure upon admission , macro vascular diseases , low density lipoprotein （ LDL ） concentrations of high-sensitive C-reactive protein （ hs-CRP ） and serum homocysteine （Hcy） between the two groups （P〈0.01 or P〈0.05）.Multiple stepwise regression analysis showed the concentration of serum Hcy was positively related with LDL and the concentration of hs-CRP .Conclusion Risk factors of patients with PS include history of hypertension , alcoholism, large-artery atherosclerosis , LDL and the increases of systolic blood pressure , concentration of hs-CRP and serum Hcy when the disease attacking .The increase of serum Hcy is a possible independent risk factor of young and middle-aged patients with PS .