Zhang Ya-Nan, He Li
Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2012 Jul;43(4):553-7.
To analyze the etiology and risk factors of ischemic stroke in young adults in Southwest of China.
This study retrospectively reviewed the 109 records of all 18-45 year-old patients who were admitted to the West China Hospital of Sichuan University from 2008 to 2010. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. We surveyed the risk factors of all the patients.
Of 109 patients (male female 1.7 : 1), the mean age of onset was (37.9 +/- 6.3) years. An increased occurrence of ischemic stroke was found in the older age group, which was significant in 40-45 years. Regarding stroke subtype, large-artery atherosclerosis was diagnosed in 57% of cases, cardioembolism in 18%, other determined etiology in 15%, stroke of small-vessel occlusion in 5.5%, and undetermined etiology in 4.5%. The older the age of the patients was, the high proportion of large-artery atherosclerosis was, and significant difference was found between each two age group (P < 0.05). In cardioembolism, the most common etiology was rheumatic heart disease with mitral stenosis and atrial fibrillation (40%). In stroke of other determined etiology, the most common etiology was dissection. The most common dissection was occurring in the vertebral system (87.5%). The most common risk factors were hypertension (36%), smoking (33%), and hypertriglyceridemia (31%).
Our study found that large-artery atherosclerosis was the most common etiology of ischemic stroke in young adults in Southwest of China, and the most common risk factors were hypertension, smoking and hypertriglyceridemia.
分析中国西南部青年缺血性脑卒中的病因及危险因素。
本研究回顾性分析了2008年至2010年四川大学华西医院收治的所有18 - 45岁患者的109份病历。病因根据急性卒中治疗中Org 10172试验(TOAST)标准进行分类。我们调查了所有患者的危险因素。
109例患者(男女比例为1.7∶1),平均发病年龄为(37.9±6.3)岁。老年组缺血性脑卒中发生率增加,在40 - 45岁组显著。关于卒中亚型,57%的病例诊断为大动脉粥样硬化,18%为心源性栓塞,15%为其他明确病因,5.5%为小血管闭塞性卒中,4.5%为病因不明。患者年龄越大,大动脉粥样硬化比例越高,各年龄组之间差异有统计学意义(P < 0.05)。在心源性栓塞中,最常见的病因是风湿性心脏病伴二尖瓣狭窄和心房颤动(40%)。在其他明确病因的卒中中,最常见的病因是夹层。最常见的夹层发生在椎体系(87.5%)。最常见的危险因素是高血压(36%)、吸烟(33%)和高甘油三酯血症(31%)。
我们的研究发现,大动脉粥样硬化是中国西南部青年缺血性脑卒中最常见的病因,最常见的危险因素是高血压、吸烟和高甘油三酯血症。