Department of Physiology, Tokai University School of Medicine, Japan.
Department of Physiology, Tokai University School of Medicine, Japan; Department of Neurology, Yokohama Brain and Spine Center, Japan.
J Neurol Sci. 2017 Sep 15;380:85-91. doi: 10.1016/j.jns.2017.07.001. Epub 2017 Jul 4.
The risk factors among the types of ischemic stroke (atherothrombotic cerebral infarction: ATI, cardio-embolic infarction: CEI, lacunar infarction: LI) in aged stroke patients have rarely been compared to each other.
We compared the clinical parameters of 300 elderly patients with ischemic stroke, age 65-98years, to 100 age-matched control patients.
Comparison by parametric test and logistic regression analysis between all 300 and 100 control patients showed higher systolic and diastolic blood pressures (p<0.001, p=0.03), lower estimated glomerular filtration rate (eGFR) (p=0.01), larger cardiothoracic ratio (CTR) (p<0.001), smoking (p<0.01) and possibly poor adherence to anti-hypertensive agents in the ischemic stroke patients (p<0.001). Comparisons among three types (n=100 for each) showed the highest atheromatous risk factors for ATI to be hemoglobin A1c (p=0.01) and low-density lipoprotein (p<0.001) and for CEI to be largest cardiac load, indicated by largest left atrial dimension (p<0.001), and CTR (p<0.001). Triglyceride level was found to be a borderline risk factor for LI (p=0.054). Comparison between those aged <74 versus ≥75years (n=150 for each) showed a lower eGFR (p=0.02) and larger right atrial dimension (p<0.001) in patients ≥75.
The risk factors were quite different among the subtypes and aging.
老年卒中患者中不同类型缺血性卒中（动脉粥样硬化性脑梗死：ATI，心源性栓塞性梗死：CEI，腔隙性梗死：LI）的危险因素很少相互比较。
我们比较了 300 名年龄在 65-98 岁的老年缺血性卒中患者和 100 名年龄匹配的对照组患者的临床参数。
对所有 300 名患者和 100 名对照组患者进行参数检验和逻辑回归分析比较，结果显示缺血性卒中患者的收缩压和舒张压较高（p<0.001，p=0.03），估算肾小球滤过率（eGFR）较低（p=0.01），心胸比（CTR）较大（p<0.001），吸烟（p<0.01）和可能对降压药物的依从性较差（p<0.001）。三种类型（每组 100 例）的比较表明，ATI 的最高动脉粥样硬化危险因素是糖化血红蛋白（p=0.01）和低密度脂蛋白（p<0.001），CEI 的最大心脏负荷由最大左心房内径（p<0.001）和 CTR（p<0.001）表示。甘油三酯水平被认为是 LI 的边缘危险因素（p=0.054）。<74 岁与≥75 岁（每组 150 例）患者的比较显示，≥75 岁患者的 eGFR 较低（p=0.02）和右心房内径较大（p<0.001）。
各亚型和年龄的危险因素有很大差异。
