Xia Yu, Liu Han, Zhu Rui, Zhou Xia, Huang Chaojuan, Sun Zhongwu
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Department of Neurology, The Third People's Hospital of Hefei (The Third Clinical College of Anhui Medical University), Hefei, Anhui, China.
Med Sci Monit. 2025 Feb 1;31:e946146. doi: 10.12659/MSM.946146.
BACKGROUND Young adults with minor ischemic stroke (MIS) often experience early onset and mild symptoms but face a high recurrence rate. Research into risk factors and etiology of young adult MIS in developing countries is limited. We investigated these aspects in young non-cardiogenic MIS patients from the Chinese Han population and identified risk factors for initial stroke and long-term poor prognosis. MATERIAL AND METHODS Data from MIS patients aged 18 to 50 years and a healthy control group at The First Affiliated Hospital of Anhui Medical University and The Third People's Hospital of Hefei City from January 2019 to July 2023 were analyzed. Risk factors and stroke etiology were compared. ROC curves assessed the predictive ability of original and modified Essen Stroke Risk Scores (ESRS). RESULTS Among 155 patients, 25 (16.1%) experienced recurrence within a year. Patients with MIS differed significantly from the control group in sex, hypertension history, diabetes, dyslipidemia, smoking, higher biomarkers (SBP, TG, VLDL-C, hs-CRP, WBC, RBC, NEUT, HB), and lower HDL-C. Univariate analysis found dyslipidemia, moderate to severe vascular stenosis, resting heart rate, and modified ESRS scores linked to recurrence. Multivariate analysis identified dyslipidemia, vascular stenosis, and resting heart rate as key risk factors. Large artery atherosclerosis was the most common stroke etiology (59.2%). ROC curves revealed areas under the curve for ESRS, modified ESRS-1, and modified ESRS-2 as 0.550, 0.660, and 0.937, respectively. CONCLUSIONS MIS was associated with a high recurrence rate and specific risk factors. Improved ESRS effectively predicted stroke recurrence within 1 year, with large artery atherosclerosis being the predominant etiology.
患有轻度缺血性卒中(MIS)的年轻人通常起病早、症状轻,但复发率高。发展中国家对年轻成人MIS的危险因素和病因的研究有限。我们对来自中国汉族人群的年轻非心源性MIS患者的这些方面进行了调查,并确定了首次卒中及长期预后不良的危险因素。
分析了2019年1月至2023年7月在安徽医科大学第一附属医院和合肥市第三人民医院就诊的18至50岁MIS患者及健康对照组的数据。比较了危险因素和卒中病因。ROC曲线评估了原始和改良的埃森卒中风险评分(ESRS)的预测能力。
155例患者中,25例(16.1%)在1年内复发。MIS患者在性别、高血压病史、糖尿病、血脂异常、吸烟、较高的生物标志物(收缩压、甘油三酯、极低密度脂蛋白胆固醇、高敏C反应蛋白、白细胞、红细胞、中性粒细胞、血红蛋白)和较低的高密度脂蛋白胆固醇方面与对照组有显著差异。单因素分析发现血脂异常、中度至重度血管狭窄、静息心率和改良ESRS评分与复发有关。多因素分析确定血脂异常、血管狭窄和静息心率为关键危险因素。大动脉粥样硬化是最常见的卒中病因(59.2%)。ROC曲线显示ESRS、改良ESRS-1和改良ESRS-2的曲线下面积分别为0.550、0.660和0.937。
MIS与高复发率和特定危险因素相关。改良的ESRS能有效预测1年内的卒中复发,大动脉粥样硬化是主要病因。