青年脑梗死患者危险因素分析

目的比较青年与中老年脑梗死患者的病因、危险因素的异同。方法回顾性分析120例青年脑梗死患者和1100例中老年患者的临床资料。结果在病因方面,根据TOAST分型,对2组间的发病率进行比较。中老年组以动脉粥样硬化为主,青年组以动脉粥样硬化和心源性因素常见。危险因素中高血脂、高同性半胱氨酸血症青年组较老年组差异有统计学意义。结论 2组病因不完全一致,需及早查找危险因素进行预防。     

115例青年脑梗死患者病因及预后分析

目的探讨青年脑梗死患者不同年龄组间的病因、危险因素及预后的差异性。方法将115例青年脑梗死患者按年龄分为青少年组（14～28岁）和青壮年组（29～40岁）,对其临床资料进行回顾性分析。结果青少年组29例,青壮年组86例;按TOAST分型,106例有病因可循,其中青少年组其他病因型最多,而青壮年组分布较分散（P〈0．05）;主要危险因素有男性及高血压病、高脂血症、吸烟和酗酒,其中性别和高血压病有组间差异（P〈0．01）。结论青年脑梗死多有明确病因,在青少年组与青壮年组间临床分布有差异,如能早发现并做针对性处理则预后较好。     

青年脑梗死危险因素及病因分析

目的了解青年脑梗死患者的危险因素及病因分型。方法回顾性分析2009-01—2011-12我院收治的73例青年脑梗死患者一般资料,收集73例同期住院的老年脑梗死患者的一般资料,比较2组患者在发病危险因素及脑梗死病因上的差异。结果青年脑梗死患者心房颤动、高同型半胱氨酸血症、发病前服用避孕药的数量明显高于老年脑梗死患者,差异有统计学意义(P<0.05)。改良TOAST分型显示,青年脑梗死患者心源性栓塞(CE)及其他明确病因型(SOD)比例明显高于老年脑梗死患者。结论青年脑梗死患者与老年脑梗死患者存在不同的危险因素,青年脑梗死发病有其特殊性,临床上应采取不同的预防措施。     

青年脑梗死相关危险因素分析

目的探讨青年脑梗死的危险因素。方法对94例青年脑梗死患者和84名同年龄健康对照患者及100例老年脑梗死患者和86名同年龄对照组患者的血脂、脂蛋白、血糖水平及血压等资料进行分析。结果青年脑梗死患者的总胆固醇、甘油三酯、低密度脂蛋白显著高于对照组，高密度脂蛋白低于对照组及老年脑梗死组。经非条件Logistic回归分析，高血压的回归系数为2．98，相对危险度为8．67；高密度脂蛋白降低的回归系数为1．75，相对危险度为5．75。结论脂质代谢异常和高血压是引起青年脑梗死的主要原因，高密度脂蛋白降低可能是脑卒中最重要的危险因素。     

61例青年脑梗死病因及危险因素的分析

目的 发现青年人脑梗死可能存在的不同病因及危险因素。方法 将61例15～40岁脑梗死患者按年龄分成两组(15～29岁一组。30～40岁一组)。再根据TOAST病因分类。将患者分成5组(ATR，CEMB。LAC，OTH，UND)。结果 61名脑梗死患者中。男39例．女22例。根据TOAST病因分类。ATR5例(8．2％)，LAC23例(37．7Vo)．CEMB10例(16．4％)．OTH17例(27．9％)。UND6例(9．8％)。结论 青年脑梗死发病原因有其特殊性，应引起临床注意。15～29岁组以其它原因所致脑梗死(OTH)和女性为主；LAC和ATR均多见于30～40岁组．且男性为多；两组心源性栓塞无明显差异。高血压、高血糖、高胆固醇血症、吸烟、饮酒作为引发青年人脑梗死的重要危险因素应积极预防和治疗。     

青年脑梗死相关危险因素分析

目的探讨青年脑梗死的危险因素。方法对94例青年脑梗死患者和84名同年龄健康对照患者及100例老年脑梗死患者和86名同年龄对照组患者的血脂、脂蛋白、血糖水平及血压等资料进行分析。结果青年脑梗死患者的总胆固醇、甘油三酯、低密度脂蛋白显著高于对照组,高密度脂蛋白低于对照组及老年脑梗死组。经非条件Logistic回归分析,高血压的回归系数为2.98,相对危险度为8.67;高密度脂蛋白降低的回归系数为1.75,相对危险度为5.75。结论脂质代谢异常和高血压是引起青年脑梗死的主要原因,高密度脂蛋白降低可能是脑卒中最重要的危险因素。     

青年脑梗死45例临床分析

目的 探讨青年脑梗死的危险因素,为更好地治疗及有效地预防青年脑梗死提供更好的依据.方法 对45例青年脑梗死患者行头颅CT、MRI、DSA、彩色多普勒及实验室检查,结合病史及复习有关资料.结果 高血压12例(占26.7%),吸烟10例(占22.2%),糖尿病6例(占13.3%),酗酒7例(占15.6%),低密度脂蛋白胆固醇(占LDL-L)升高者10例(占22.2%),家族史者5例(占11.1%).结论 高血压,吸烟饮酒,高胆固醇血症及脂质代谢异常是引起青年脑梗死主要危险因素,只有对这些危险因素早期加予干预,才能降低青年脑梗死的发病率.     

青年脑梗死相关危险因素分析

目的探讨青年脑梗死患者的危险因素。方法选择2006-01-2008-12住院的脑卒中患者共114例,年龄26～45岁,男76例,女38例,对已知危险因素进行分析。结果高血压、高脂血症、糖尿病、吸烟、过量饮酒是主要危险因素。超重及肥胖在青年脑梗死患者中所占的比例也较高。结论健康的生活方式,戒烟限酒,降压降脂治疗是青年脑梗死一级预防的重要措施,对控制危险因素有积极意义。     

青年与中老年脑梗死的对比研究

目的 探讨青年与中老年脑梗死危险因素及病因的不同。 方法 将148例青年脑梗死患者分为18～35岁组和36～45岁组,同期232例中老年脑梗死患者作为对 照组,比较3组患者危险因素暴露率和病因的不同。 结果 （1）18～35岁组前3位危险因素是高同型半胱氨酸血症（hyperhomocysteinemia,HHcy）（66.7%）、 高脂血症（40.7%）和高血压病（33.3%）;36～45岁组前3位危险因素是高血压病（59.5%）、HHcy （56.2%）和高脂血症（47.1%）;中老年组前3位危险因素是高血压病（72.4%）、HHcy（54.7%）和高脂 血症（48.7%）。（2）3组患者间高血压病、糖尿病、大量吸烟暴露率有显著差异,其中,18～35岁组（P ＜0.001,P =0.014）和36～45岁组（P＜0.001,P＜0.001）的高血压病、糖尿病暴露率均显著低于中老 年组,18～35岁组高血压病、糖尿病暴露率显著低于36～45岁组（P =0.009,P＜0.001）;18～35岁组大 量吸烟暴露率低于36～45岁组和中老年组（P =0.006,P＜0.001）。（3）18～35岁组急性卒中治疗低分 子肝素试验（Trial of Org 10 172 In Acute Stroke Treatment,TOAST）分型以不明原因型构成比最高, 显著高于中老年组（37.0% vs 27.6%,P =0.013）。36～45岁组和中老年组均以大动脉粥样硬化型构成 比（50.4%和58.2%）最高,均显著高于18～35岁组的25.9%（P =0.021,P =0.014）。 结论 36～45岁青年组与中老年组相似,前3位危险因素依次是高血压病、HHcy和高脂血症,病因以 大动脉硬化为主;18～35岁青年组则不同,前3位危险因素依次是HHcy、高脂血症和高血压病,病因 不明者居多。     

青年脑梗死与老年脑梗死的危险因素及临床特点对比分析

目的分析青年和老年脑梗死患者的危险因素及临床特点,以提高预防和治疗效果。方法回顾性分析2006年1月～2008年12月在本科住院的103例青年脑梗死患者,127例老年脑梗死患者的临床资料,比较2组危险因素、梗死分型和临床表现。结果糖尿病、高同型半胱氨酸血症、吸烟和饮酒为青年脑梗死的重要危险因素,而高血压病、CRP和冠心病为老年脑梗死的重要危险因素,2组比较差别有显著性意义（P〈0.05）。结论青年与老年脑梗死患者的危险因素不同,应采取不同的预防措施。青年人脑梗死危险因素更为复杂多样,很多危险因素可以提前干预,健康的生活方式对预防本病非常重要,应加强脑血管疾病的一级预防。     

Hormonal changes in cerebral infarction in the young and elderly

Fifty-one patients with CCT verified cerebral infarction were submitted to serum and CSF radioimmunoassay of FSH, LH, estradiol (E2), progesterone, testosterone, cortisol and T4. The results were compared to those of 82 matched controls. Our findings suggest that (1) high serum E2 is a risk factor of stroke in males; (2) low serum T4 is a risk factor in males; (3) serum testosterone is reduced in acute stroke in males confirming that it is stress sensitive; (4) serum LH was higher in hypertensive thrombotic males when compared to normotensive ones, and (5) FSH, LH, E2 and T4 are undetectable in CSF of patients and controls.     

Electrocardiogram cerebral infarction changes in acute patients

BACKGROUND: Comparison of different stroke locations had been focused in past researches in electrocardiogram (ECG) changes of cerebral stroke patients. Some researches neglected the heart disease in the illness history. OBJECTIVE: To discuss ECG changes in different infarction locations and size of acute cerebral infarction and compare with healthy people. DESIGN: Contrast observation. SETTING: Shanghai Ninth People's Hospital. PARTICIPANTS: A total of 57 patients with cerebral infarction were selected from the Neurological Department of Ninth People's Hospital of Shanghai from March 2003 to September 2005. They were diagnosed according to the criteria revised in the 4th National Cerebral Disease Conference and brain images. Patients who had heart disease were excluded. There were 32 males and 25 females, who were 65-84 years old. Among them, 23 cases were involved in right hemisphere, 34 cases in left one, 23 in base ganglion, 11 in brain stem, 9 in frontal lobe and 14 in other parts. According to their infarction size (plus size in every different scan), they were divided into three different groups: large-size group (n = 10) with size larger than 3.5 cm3, medium-size group (n = 13) with size between 1.5-3.5 cm3, and small-size group (n = 34) with size smaller than 1.5 cm3. Another 50 healthy subjects were regarded as control group. There were 29 males and 21 females aged 40-82 years. All these cases knew and agreed of the examination. METHODS: Patients received 12-lead ECG examinations within the first 6-24 hours of onset while control group received it at the same time. The HR, PR, QTc, QRS, T wave and ST changes were compared between the two groups. MAIN OUTCOME MEASURES: The ECG changes and differences in two hemispheres, in different infarction locations and sizes. RESULTS: All 57 patients and 50 healthy subjects were involved in the final analysis. ① ECG changes in infarction group and control group. There were no differences in HR, QRS time and cases with opposite T wave of infarction group compared with control group (P > 0.05). PR and QTc [(0.167±0.010), (0.383±0.029) s] in infarction group were longer than those in control group [(0.159±0.008), (0.361±0.022) s, t = 1.982, 2.363, P < 0.05, 0.01]. ST changes cases were 77% (44/57), which was more than those in control group [46% (23/50), χ2 = 11.072, P < 0.01]. ② Comparison of infarction in two hemispheres. HR, PR interval, QRS time, cases with opposite T wave and ST changes showed no differences (P > 0.05), and QTc interval in right hemisphere infarction was longer than left one [(0.391±0.054), (0.380±0.034) s, t =1.673, P < 0.05]. ③ ECG changes in different infarction locations. HR, PR interval, QTc interval, QRS time, cases with opposite T wave and ST changes showed no statistically significantly differences (P > 0.05). ④ ECG changes in different infarction sizes. HR, PR interval, QRS time showed no differences (P > 0.05). QTc interval in large size group was longer than the others [(0.399±0.044), (0.388±0.073), (0.378±0.124) s, F = 3.19, P < 0.05]. Cases with opposite T wave and ST changes in large size group were 80% (8/10), 100% (10/10), which were higher than those in medium size group [46% (6/13), 69% (9/13)] and small size group [44% (15/34), 35% (12/34), χ２ = 8.495, 10.538, P < 0.05, 0.01]. CONCLUSION: ① PR interval and QTc interval prolonged in cerebral infarction patients. Furthermore, QTc interval was more obvious in large size infarction group and right hemisphere infarction group. ② Infarction location did not affect the changes of ECG.     

无脑动脉狭窄急性脑梗死患者的临床特点

目的 探讨无脑动脉狭窄急性脑梗死(ACI)患者的临床特点.方法 对352例ACI患者进行数字减影全脑血管造影(DSA),根据检查结果分为无动脉狭窄组和动脉狭窄组,比较两组患者临床神经功能缺损评分、卒中危险因素和预后;并比较无动脉狭窄组中前循环梗死亚组与后循环梗死亚组的病情和预后.结果 根据DSA结果,无动脉狭窄组70例,动脉狭窄组282例.无动脉狭窄组患者合并高血压、糖尿病以及既往腩卒中、冠心病史者的比率明显低于动脉狭窄组(P<0.05～0.01);入院时及发病3个月时美国国立卫生研究院卒中鼍表(NIHSS)评分均明显低于动脉狭窄组,改良Rankin量表(mRS)评分及3个月卒中复发或死亡率明显低于动脉狭窄组(P<0.05～0.01);无动脉狭窄组中后循环梗死亚组患者入院时及发病3个月时NIHSS、mRS评分及死亡率明显高于前循环梗死亚组(P<0.05～0.01).结论 无明显脑动脉狭窄ACI患者的病情较轻,预后较好;但其中后循环梗死患者预后较差.     

65例青年人脑梗死的临床特点

目的分析青年人脑梗死的临床特点。方法回顾性分析65例青年脑梗死患者的临床资料，探讨其病因、危险因素和预后等临床特点。结果有明确病因者38例（58．46％），其中动脉粥样硬化25例（38．46％），心源性脑栓塞10例（15．38％），梅毒性动脉炎2例（3．08％），真性红细胞增多症1例（1．54％）；病因不明者27例（41．54％）。主要危险因素有吸烟、高血压、血脂异常、脑血管疾病家族史、肥胖、酗酒、TIA病史、糖尿病、房颤等。经治疗基本痊愈22例（33．85％），显著进步16例（24．62％），进步13例（20．00％），无变化14例（21．54％）。结论青年人脑梗死的病因以动脉粥样硬化、心源性脑栓塞、梅毒性动脉炎最常见。以吸烟、高血压、血脂异常等为最常见的危险因素，大多数患者预后较好。     

65例青年人脑梗死的临床特点

目的分析青年人脑梗死的临床特点。方法回顾性分析65例青年脑梗死患者的临床资料,探讨其病因、危险因素和预后等临床特点。结果有明确病因者38例(58.46%),其中动脉粥样硬化25例(38.46%),心源性脑栓塞10例(15.38%),梅毒性动脉炎2例(3.08%),真性红细胞增多症1例(1.54%);病因不明者27例(41.54%)。主要危险因素有吸烟、高血压、血脂异常、脑血管疾病家族史、肥胖、酗酒、TIA病史、糖尿病、房颤等。经治疗基本痊愈22例(33.85%),显著进步16例(24.62%),进步13例(20.00%),无变化14例(21.54%)。结论青年人脑梗死的病因以动脉粥样硬化、心源性脑栓塞、梅毒性动脉炎最常见。以吸烟、高血压、血脂异常等为最常见的危险因素,大多数患者预后较好。     

EEG in elderly cardiac patients without cerebral lesions]

Ageing is known to be accelerated by risk-factors. The continuity between normal and pathological ageing is still quite disputed. Concerning cerebral ageing, the use of statistical methods on electroencephalographic (EEG) parameters appeared to be interesting. In this study, three different groups of elderly subjects were examined by EEG: normal subjects without neurological nor cardiac disease, subjects with Alzheimer-dementia (AD) and cardiac patients without cerebral clinical signs. Stepwise discriminant analysis showed that EEG-parameters discriminating normal subjects from cardiac patients were different from those discriminating AD-patients from normal. Furthermore, AD-patients could be well-discriminated from elderly cardiac patients.     

Nonhemorrhagic cerebral infarction in young adults

We evaluated 144 patients (81 males and 63 females) aged 15 to 45 years who had nonhemorrhagic cerebral infarction. Atherosclerotic cerebral infarction was diagnosed in 38 patients. Potential cardiac causes of cerebral embolism were found in 33 patients. Only three events could be attributed to mitral valve prolapse. Hematologically related disorders were diagnosed in 21 patients, while 38 patients had nonatherosclerotic vasculopathies. Young patients with cerebral infarction are a heterogeneous group. A potential cause can be found in most patients. We found more than 40 possible etiologies among our patients. Mitral valve prolapse apparently is not a common cause of cerebral infarction among young adults. Cerebral infarction should not be ascribed to oral contraceptives or migraine until other possible causes have been eliminated.     

Ischaemic cerebral infarction in young adults

Fifty six patients aged 17 to 45 years who had Ischemic Cerebral Infarction (I.C.I.) were studied. The following etiologies were established: 1. Juvenile atherosclerosis (21 patients); 2. Cerebral embolism either from cardiac (10 patients) and from unknown source (3 patients); 3. Secondary coagulopathies (4 patients); 4. Non atherosclerotic vasculopathies (6 patients); 5. Traumas of skull and neck (3 patients); 6. Migraine (2 patients); 7. Oral contraceptives use (1 patient). In 6 cases the etiology remained unknown. Young subjects with I.C.I. are a heterogeneous group: however in most of them a reasonable cause can be found. The occurrence of acute death (14%) was high, while recurrent stroke (5%) and non acute death (3%) were rare when compared to older patients. At the follow-up 80% had a very little residual motor deficit but only 43% were able to return to previous work.     

Different independent susceptibility markers for first-ever cerebral infarction and myocardial infarction in young patients

Cerebral infarction (CI) and myocardial infarction (MI) share some common features, but there are other differences in risk factors. The aim of our study is to determine whether there are some significantly independent susceptibility markers for them. All consecutive patients between the ages of 18 and 45 years with first-ever CI and MI during 2001-2010 were recruited to participate in the study. Using multivariate logistic regression modeling, we explore many different data, such as age at onset, sex ratio, numbers of patients with history of hypertension, smoking, drinking, and serum lipid, uric acid, prealbumin (PA), and white blood cell (WBC) count levels. Logistic regression analysis adjusted for confounders confirmed the following independent susceptibility markers for young CI patients: hypertension, admission serum PA levels, daily alcohol [odds ratio (OR), 0.251; 95% confidence interval (CI), 0.097-0.648, p = 0.004; OR, 0.994; 95% CI, 0.988-0.999, p = 0.031; OR, 0.150; 95% CI, 0.047-0.473, p = 0.001], and for MI patients: age at onset, current smoking, serum WBC, and glucose levels (OR, 1.293; 95% CI, 1.146-1.457, p = 0.000; OR, 8.914; 95% CI, 3.575-22.231, p = 0.000; OR, 1.344; 95% CI, 1.169-1.544, p = 0.000; OR, 1.149; 95% CI, 1.022-1.291, p = 0.020). We conclude that there are some significantly different independent susceptibility markers for young CI and MI patients.     

脑梗死并高血压病患者左心功能的研究

目的探讨脑梗死合并高血压病患者左心功能的变化。方法以脑梗死合并高血压病患者(50例)为A组,以单纯高血压病患者(50例)和单纯脑梗死患者(50例)为B组,收集他们的相关超声学指标(左心室收缩功能指标:心指数、射血分数、短轴缩短率;舒张功能指标:等容舒张时间、E/A比值、E波减速时间;整体功能指标:Tei指数;左心房功能指标:左心房内径),采用方差分析及q检验进行统计分析。结果与B组相比,A组的左心室收缩功能无显著改变(P>0.05),左心室舒张功能、整体功能及左心房功能均降低(P<0.05)。结论脑梗死并高血压病患者左心室收缩功能无明显受损,左心室舒张功能及左心房功能明显受损。