Santonja J M, Vicent V, Pareja A, Láinez J M, Sancho-Rieger J
Servicio de Neurologia, Hospital General Universitario de Valencia, España.
Rev Neurol. 1998 May;26(153):787-9; discussion 789-90.
Few studies have been made of the prognosis of ictus in the young adult. The objective of this paper is to study the short term evolution of 167 patients, aged between 15 and 45 years, with cerebral vascular disease.
Since 1986 a protocolized study has been made of all patients aged between 15 and 45 who were admitted to the Neurology Department of the Hospital General Universitario in Valencia for a cerebral vascular incident. The results obtained up to 1993 have been recorded in a data base. In this paper the demographic data and information as to intrahospital evolution have been used with the Canadian, modified Rankin and Barthel Scales in the various ictus groups.
28.7% of the patients were AIT and 71.3% were diagnosed as established ictus, of whom 38.8% were haemorrhagic and 61.2% were ischaemic. 29.8% of the HIP, 33.3% of the embolic infarcts and 18.2% of the atherothrombotic infarcts were severely disabled on discharge from hospital. Mortality was 4.2% when AIT were excluded.
Most studies are basically aetiopathological and much fewer include evaluation of prognosis. In our series, the patients had a satisfactory clinical course and low short-term mortality. As in the other series, the two groups with the worst prognosis were the HIP and the cardioembolic infarcts. Patients with HSA and HIV made outstandingly good progress.
针对青年成人卒中预后的研究较少。本文的目的是研究167例年龄在15至45岁之间的脑血管疾病患者的短期病情演变。
自1986年起，对所有年龄在15至45岁之间、因脑血管事件入住巴伦西亚综合大学医院神经科的患者进行了一项规范化研究。截至1993年获得的结果已记录在一个数据库中。在本文中，使用了不同卒中组中加拿大、改良Rankin和Barthel量表的人口统计学数据以及院内病情演变信息。
28.7%的患者为急性缺血性卒中（AIT），71.3%被诊断为确诊卒中，其中38.8%为出血性，61.2%为缺血性。29.8%的高血压性脑出血（HIP）、33.3%的栓塞性梗死和18.2%的动脉粥样硬化血栓形成性梗死患者出院时严重残疾。排除AIT后死亡率为4.2%。
大多数研究基本上是病因病理学方面的，而涉及预后评估的较少。在我们的系列研究中，患者的临床病程良好，短期死亡率较低。与其他系列研究一样，预后最差的两组是HIP和心源性栓塞性梗死。患有高血压性脑出血（HSA）和人类免疫缺陷病毒（HIV）的患者病情进展非常良好。
