缺血性脑卒中病因分型与临床预后的关系

目的探讨缺血性脑卒中TOAST病因分型与临床预后的关系。方法采用前瞻性队列研究方法,将连续入选的421例首发急性缺血性脑卒中患者的临床资料,按照TOAST分类标准进行病因分型,共分为5个亚型:大动脉粥样硬化型(LAA,73例)、心源性栓塞型(CE,39例)、小动脉闭塞型(SA().130例)、其他明确病因型(SOE,1例)和不明病因型(SUE,178例)。分析各亚型构成、相关危险因素及复发的关系。随访1年,记录终点事件。结果与其他各亚型比较,CE年龄高,男性比例少,差异有统计学意义(P<0.05);CE 1年复发率最高(33.3%)、SAO最低(6.9%);各亚型之间吸烟、高血压、糖尿病、心脏病、TC、LDL-C、纤维蛋白原、血糖比较,差异均有统计学意义(P<0.05)。结论 TOAST病因分型可以为缺血性脑卒中二级预防提供参考依据。

The relationship between ischemic stroke subtypes according to the TOAST criteria and clinical prognosis

Objective To analyse the relationship between ischemic stroke subtypes according to the TOAST criteria and clinical prognosis. Methods The clinical data of the first-ever ischemic stroke patients were collected prospectively. 421 patients were classified into 5 major ischemic stroke subtypes according to TOAST criteria. All cases were followed up for a year since the first event. The recurrent ischemic strokes and the death owing to the recurrence were recorded. Results The statistical difference between sexes and ages of each subtype was significant (P< 0.05). The recurrent rates of different TOAST subtypes in a year were as follows:cardioembolism subtype 33.3% ,small artery occlusion subtype 6.9%. There were significant differences in following risk factors among different ischemic stroke subtypes: smoking,hypertension,diabetes, cardiac disease, TC, LDL, Fib and GLU (P<0.05). Conclusions TOAST classification as an etiological classification is useful to secondary prevention of ischemic stroke.