Li Fang, Yang Li, Yang Rui, Xu Wei, Chen Fu-Ping, Li Nan, Zhang Jin-Biao
Department of Neurology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, PR China.
Eur Neurol. 2017;77(3-4):115-122. doi: 10.1159/000455093. Epub 2017 Jan 5.
Young adults accounted for 10-14% of ischemic stroke patients. The risk factors may differ in this population from elder patients. In addition, the factors associated with stroke recurrence in this population have not been well investigated.
The study aimed to investigate the characteristics and risk factors associated with recurrence of ischemic stroke in young adults.
Clinical data of 1,395 patients of age 18-45 years who were treated between 2008 and 2014 in 3 centers located in northern China was reviewed. The first onset of stroke was taken as the initial events and recurrent stroke as the end point events. The end point events, age, gender, duration after first onset of stroke, history of disease, National Institutes of Health Stroke Scale (NIHSS) score at admission, Trial of Org 10172 in Acute Stroke Treatment classifications of the cause of stroke and adherence to medication were recorded. These factors were analyzed and compared between recurrence and non-recurrence group. Information about recurrent stroke was collected through clinical (readmission to hospital with ischemic stroke) or telephone follow-up survey. Logistic regression was used to analyze the risk factors of recurrence.
The most common causes of stroke were large vessel atherosclerosis and small vessel occlusion, followed by cardioembolism. NIHSS score at admission (OR 1.088; 95% CI 1.028-1.152; p = 0.004) were associated with recurrence.
Vascular disease, especially premature atherosclerosis, is the major risk factor for ischemic stroke in the young adult population of northern China. Timely screening of the cause of stroke with severe NIHSS score needs further attention.
青年成年人占缺血性脑卒中患者的10 - 14%。该人群的危险因素可能与老年患者不同。此外,该人群中与脑卒中复发相关的因素尚未得到充分研究。
本研究旨在调查青年成年人缺血性脑卒中复发的特征及危险因素。
回顾了2008年至2014年在中国北方3个中心接受治疗的1395例年龄在18 - 45岁患者的临床资料。将首次脑卒中发作作为起始事件,复发性脑卒中作为终点事件。记录终点事件、年龄、性别、首次脑卒中发作后的病程、疾病史、入院时美国国立卫生研究院卒中量表(NIHSS)评分、急性卒中治疗中Org 10172试验的卒中病因分类以及服药依从性。对复发组和非复发组的这些因素进行分析和比较。通过临床(因缺血性脑卒中再次入院)或电话随访调查收集复发性脑卒中的信息。采用逻辑回归分析复发的危险因素。
脑卒中最常见的病因是大动脉粥样硬化和小血管闭塞,其次是心源性栓塞。入院时的NIHSS评分(OR 1.088;95%CI 1.028 - 1.152;p = 0.004)与复发相关。
血管疾病,尤其是过早的动脉粥样硬化,是中国北方青年成年人群缺血性脑卒中的主要危险因素。对NIHSS评分高的脑卒中病因进行及时筛查需要进一步关注。