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青年成人颈内动脉夹层所致缺血性卒中——一项回顾性研究

Ischemic Stroke in Young Adults Caused by Cervical Artery Dissection-A Retrospective Study.

作者信息

Jazbec Lucija, Menih Marija, Arh Rok

机构信息

Faculty of Medicine, University of Maribor, Maribor, Slovenia.

Department of Neurology, University Medical Centre Maribor, Maribor, Slovenia.

出版信息

Int J Angiol. 2021 Dec 31;31(2):126-130. doi: 10.1055/s-0041-1740318. eCollection 2022 Jun.

Abstract

Ischemic stroke is one of the most common causes of death and disability. The most common independent cause is cervical artery dissection, which represents around 20% of all cases of ischemic stroke in young adults. Risk factors for dissection include male gender, migraine (particularly with aura), hyperhomocysteinemia, recent infection, recent history of minor cervical trauma, young age, current smoking status, increased leucocyte count, and shortened activated partial thromboplastin time, whereas hypercholesterolemia and being overweight appear protective.  This retrospective study was based on data of all patients aged 18 to 49 who were hospitalized in the University Medical Centre Maribor for ischemic stroke between 2010 and 2019 inclusive. The results of the research were analyzed by IBM SPSS Statistics 28 software. For statistical significance, a cut-off value of  < 0.05 was used.  The study includes 196 patients with 198 events of ischemic stroke. Dissection of cervical arteries was presented in 16 (8.2%) cases. The presence of arterial hypertension proved to have a relation with the presence of a dissection; patients with dissection are less likely to suffer from arterial hypertension. Duration of hospitalization in the group with dissection lasted significantly longer than in the group without dissection.  Dissection of cervical or intracranial artery is an important cause of ischemic stroke, especially in young adults. Therefore, it should be considered in young adults with presentation of stroke who lack traditional and modifiable risk factors.

摘要

缺血性中风是死亡和残疾的最常见原因之一。最常见的独立病因是颈动脉夹层,约占年轻成人缺血性中风所有病例的20%。夹层的危险因素包括男性、偏头痛(尤其是伴有先兆)、高同型半胱氨酸血症、近期感染、近期轻微颈部外伤史、年轻、当前吸烟状况、白细胞计数增加和活化部分凝血活酶时间缩短,而高胆固醇血症和超重似乎具有保护作用。

这项回顾性研究基于2010年至2019年(含)期间在马里博尔大学医学中心因缺血性中风住院的所有18至49岁患者的数据。研究结果采用IBM SPSS Statistics 28软件进行分析。为了具有统计学意义,使用的临界值为<0.05。

该研究包括196例患者,发生了198次缺血性中风事件。16例(8.2%)出现颈动脉夹层。事实证明,动脉高血压的存在与夹层有关;有夹层的患者患动脉高血压的可能性较小。有夹层的组住院时间明显长于无夹层的组。

颈部或颅内动脉夹层是缺血性中风的一个重要原因,尤其是在年轻成人中。因此,对于出现中风但缺乏传统且可改变危险因素的年轻成人应予以考虑。

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本文引用的文献

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Ischemic Stroke in Young Adults.青年缺血性脑卒中
Continuum (Minneap Minn). 2020 Apr;26(2):386-414. doi: 10.1212/CON.0000000000000833.
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Stroke in the Young: a Global Update.青年卒中:全球更新。
Curr Neurol Neurosci Rep. 2019 Nov 25;19(11):91. doi: 10.1007/s11910-019-1004-1.
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Ischaemic stroke.缺血性脑卒中。
Nat Rev Dis Primers. 2019 Oct 10;5(1):70. doi: 10.1038/s41572-019-0118-8.

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