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老年人缺血性中风:七十多岁老人与八十多岁老人的对比

Ischemic Stroke in the Elderly: Septuagenarians Versus Octogenarians.

作者信息

Baştan Birgül, Günaydin Sefer, Balci Fatma Belgin, Acar Hürtan, Mutlu Aytül, Özer Feriha, Çokar Özlem

机构信息

Clinic of Neurology, Haseki Training and Research Hospital, İstanbul, Turkey.

出版信息

Noro Psikiyatr Ars. 2016 Dec;53(4):334-337. doi: 10.5152/npa.2016.15923. Epub 2016 Dec 1.

Abstract

INTRODUCTION

Stroke prevalence is known to increase with age. Approximately 50% of acute ischemic stroke patients are aged between 70 and 89 years.

METHODS

In this study, records of 770 ischemic stroke patients who were 70-89 years old were retrospectively examined (407 septuagenarians and 363 octogenarians). The demographics, comorbid conditions, ischemic stroke type, and stroke outcome for the two age groups were analyzed.

RESULTS

Comorbid hypertension, diabetes mellitus, and HbA1c levels of ≥6.5% more frequently occurred in septuagenarians than in octogenarians (80.6% versus 70.8%, p=0.002; 32.2% versus 21.8%, p=0.001; and 35% versus 23.2%, p=0.003, respectively), whereas atrial fibrillation was significantly higher in octogenarians (49.3% versus 41.5%, p=0.03). Hypercholesterolemia, previous stroke history, and antiaggregant and/or anticoagulant use were not significantly different between the two age groups. Based on the Oxfordshire Community Stroke Project classification, the most common stroke subtype in the septuagenarian group was a lacunar infarction and in the octogenarian group, it was a partial anterior circulation infarct. According to the Modified Ranking Score, the number of patients living independently was higher for septuagenarians (42.8% versus 27.8%, p<0.001).

CONCLUSION

The present findings indicate that the clinical characteristics of ischemic stroke differed between septuagenarians and octogenarians. Therefore, elderly stroke patients cannot be accepted as a homogeneous group. Because this is a hospital-based study, our findings need to be tested via additional epidemiological studies.

摘要

引言

已知中风患病率随年龄增长而增加。约50%的急性缺血性中风患者年龄在70至89岁之间。

方法

在本研究中,对770名年龄在70 - 89岁的缺血性中风患者的记录进行了回顾性检查(407名七十多岁的患者和363名八十多岁的患者)。分析了两个年龄组的人口统计学特征、合并症、缺血性中风类型和中风结局。

结果

七十多岁患者合并高血压、糖尿病以及糖化血红蛋白水平≥6.5%的情况比八十多岁患者更常见(分别为80.6%对70.8%,p = 0.002;32.2%对21.8%,p = 0.001;35%对23.2%,p = 0.003),而八十多岁患者的房颤发生率显著更高(49.3%对41.5%,p = 0.03)。高胆固醇血症、既往中风史以及抗血小板和/或抗凝药物的使用在两个年龄组之间无显著差异。根据牛津郡社区中风项目分类,七十多岁组最常见的中风亚型是腔隙性梗死,八十多岁组是部分前循环梗死。根据改良Rankin评分,七十多岁患者独立生活的人数更多(42.8%对27.8%,p < 0.001)。

结论

目前的研究结果表明,七十多岁和八十多岁缺血性中风患者的临床特征存在差异。因此,老年中风患者不能被视为一个同质化群体。由于这是一项基于医院的研究,我们的研究结果需要通过额外的流行病学研究进行验证。

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