青年缺血性卒中75例临床特点分析

目的分析青年缺血性卒中病人的临床特点，指导青年缺血性卒中的防治。方法选取2014-2017年神经内科住院的75例青年缺血性卒中病人作为青年卒中组，选取同期住院的80例中老年缺血性卒中病人作为中老年卒中组，进行危险因素、中国缺血性卒中（CISS）分型、脑动脉狭窄分布和预后评价的分析。结果2组性别分布差异无统计学意义（P>0.05）。中老年卒中组高血压、糖尿病、高脂血症、既往短暂性脑缺血发作病史率高于青年组，而吸烟、酗酒、高同型半胱氨酸血症率低于青年组（P＜0.05~P＜0.01）；青年卒中组在CISS分型上以大动脉粥样硬化型为主（53.33%），2组CISS亚型分布差异具有统计学意义（P＜0.05）。青年卒中组前循环狭窄率高于中老年组，而后循环狭窄低于中老年组（P＜0.05）。青年卒中组预后效果明显优于中老年卒中组，2组预后评分差异具有统计学意义（P＜0.01）。结论吸烟、酗酒、高同型半胱氨酸血症已经成为青年缺血性卒中的常见危险因素；在CISS分型中，大动脉粥样硬化型常见分型；狭窄部位以前循环狭窄为主；同时短期预后优于中老年卒中病人。

Clinical characteristics analysis of ischemic stroke in 75 young patients

ObjectiveTo analyze the clinical characristics of ischemic stroke in young patients, and provide the guidance in prevention and treatment of disease.MethodsSeventy-five young patients with ischemic stroke and 80 middle-aged and old patients with ischemic stroke were divided into the young group and middle-aged and old group, respectively.The risk factors, Chinese ischemic stroke subclassification(CISS) typing, cerebral artery stenosis and prognosis in two groups were evaluated.ResultsThe difference of gender distribution between two groups was not statistically significant(P>0.05).The incidence rates of hypertension, diabetes mellitus, hyperlipidaemia, TIA disease history in middle-aged and old group were higher than those in young group, and the incidence rates of smoking, alcoholism and hyperhomocysteinemia in middle-aged old group were lower than those in young group(P < 0.05 to P < 0.01).The large-artery atherosclerosis in young group was the main type of CISS classification(53.3%), and the difference of CISS subtype between two groups was statistically significant(P < 0.05).The anterior circulation stenosis rate in young group was higher than that in middle-aged and old group, but the posterior circulation stenosis rate in young group was lower than that in middle-aged and old group(P < 0.05).The prognosis in young group was significantly better than that in middle-aged and old group(P < 0.05).The difference of the prognosis score between two groups was statiscally siginificant(P < 0.01).ConclusionsSmoking, alcoholism and hyperhomocysteinemia are the most common risk factors in young patients with ischemic stroke.LAA is the most common subtype of CISS.The anterior circulation stenosis is more.The short-term prognosis in young patients with ischemic stroke is better than that in middle-aged and old patients with ischemic stroke.