前后循环脑梗死危险因素、TOAST病因分型及预后分析

摘要

Objective To study stroke common risk factors,TOAST subtypes and prognosis in the anterior and posterior circulation infarction.Methods Five hundred and seven patients with anterior circulation infarction and 114 patients with posterior circulation infarction were prospectively analyzed in common risk factors,TOAST subtypes and their prognosis.Results Hypertension was a major risk factor in anterior circulation infarction and posterior circulation infarction (58.2％ vs 63.2％),this difference was not statistically significant (P ＞ 0.05).The prevalence of smoking and hyperlipidemia in anterior circulation infarction was lower than the posterior circulation infarction,and the prevalence of atrial fibrillation in anterior circulation infarction was higher than that in posterior circulation infarction (P ＜ 0.05).The prevalence of cardioembolic strokes in anterior circulation infarction was higher than that in posterior circulation infarction (P =0.042).At the end of 3 and 6 months follow-up,patients with anterior circulation infarction had higher matality rate and poorer prognosis rate than patients with posterior circulation infarction (P ＜0.05).Conclusions There are some differences in stroke common risk factors,subtypes and outcomes between anterior and posterior circulation infarction,patients with anterior circulation infarction remained more diabled than patients with posterior circulation infarction,which needs to be verified by future studies.%目的 了解前后循环脑梗死患者常见的危险因素、病因分型及预后的差异,以利于进行针对性防治.方法 连续收集前后循环脑梗死住院患者507例和114例,收集相关的危险因素,对其进行TOAST病因分型,在发病3个月和6个月后进行随访,对前后循环脑梗死中常见发病危险因素、类型及预后进行比较分析.结果 高血压是前后循环脑梗死患者最常见的危险因素,分别占58.2％和63.2％,两组比较差异无统计学意义(P＞0.05).前循环组中吸烟和高脂血症比例低于后循环组,房颤比例高于后循环组(P＜0.05).前循环脑梗死中心源型栓塞型卒中比例高于后循环组(P =0.042).后循环脑梗死患者在3个月和6个月的随访中病死率和预后不良发生率低于前循环组(P＜0.05).结论 前后循环脑梗死患者常见危险因素和病因分型存在着一定差异.前循环脑梗死患者3个月和6个月的预后较后循环脑梗死患者差,其结果需要进一步的研究来证实.