青年脑梗死患者发病危险因素临床分析

摘要

Objective To analyze the risk factors of young cerebral infarction caused by large artery atherosclerosis (LAA) or penetrating artery disease(PAD) ,and to provide the basis for clinical application .Methods A total of 120 patients with cerebral infarction caused by LAA or PAD diagnosed in our hospital under 45 years old were selected as the study subjects ,and 120 cases non-stroke young under 45 years old in the same period were selected as a control group .We compared their clinical data including hypertension ,smoking ,sleep-disordered breathing ,fasting blood glucose (FBG) ,glycosylated hemoglobin A1c(HbA1c) ,uric acid (UA) ,total cholesterol(TG) ,low-density lipoprotein-C(LDL-C) ,high-density lipoprotein-C(HDL-C) ,triglyceride (TC) ,homo-cysteine (HCY) ,to explore the risk factors for the incidence of young cerebral infarction caused by LAA or PAD .Results Hyper-tension of the case group was significantly higher than that of the control group ,the difference was statistically significant ;The lev-el of UA in the case group was (409.56 ± 149.931 ) umol/L ,which was significantly higher than that in the control group (375.53 ± 106.184 umol/L) ,and the difference was statistically significant .The level of TC in case group was (2.325 ± 1.753) mmol/L ,which was significantly higher than that in control group (1.874 ± 1.494) mmol/L ,the difference was statistically sig-nificant .Logistic regression analysis showed that hypertension ,uric acid and triglyceride were positively correlated with the inci-dence of cerebral infarction in young patients caused by LAA and PAD (P<0.05) .Conclusion Hypertension ,uric acid and tri-glyceride are independent risk factors for the development of cerebral infarction in young patients caused by LAA and PAD .Con-trolling of young people's hypertension ,uric acid and triglyceride can reduce the incidence of such young cerebral infarction ,and has positive significance for the first-degree prevention of such young cerebral infarction .%目的 分析大动脉粥样硬化和小血管病变青年脑梗死发病危险因素,为临床应用提供依据.方法 选择120例中山市人民医院确诊为脑梗死的45岁以下、病因分型为大动脉粥样硬化或小血管病变的患者作为观察对象,以同期非卒中青年120例作为对照组,比较2组血压、吸烟史、睡眠呼吸障碍病史、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血尿酸(UA)、总胆固醇(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、甘油三酯(TC)、血同型半胱氨酸(Hcy)等指标,探讨分析大动脉粥样硬化和小血管病变青年脑梗死发病的危险因素.结果 病例组血压水平明显高于对照组,差异有统计学意义;病例组UA水平(409.56±149.931)μmol/L,明显高于对照组(375.53±106.184)μmol/L,差异有统计学意义;病例组甘油三酯水平(2.325±1.753)mmol/L,明显高于对照组(1.874±1.494)mmol/L,差异有统计学意义;通过Logistic回归分析,血压、血尿酸、甘油三酯水平与大动脉粥样硬化和小血管病变青年脑梗死发病呈正相关(P<0.05).结论 血压、尿酸、甘油三酯是大动脉粥样硬化和小血管病变青年脑梗死发病的独立危险因素.控制青年人群血压、血尿酸及甘油三酯水平可减少此类青年脑梗死的发病率,对此类青年脑梗死的Ⅰ级预防有积极意义.