青年脑梗死TOAST分型及危险因素分析

摘要

Objective:To analyze causes and risk factors in youth cerebral infarction.Method:A total of 156 cases of cerebral infarction in youth patients were classified into different types according to the TOAST and the risk factors were analyzed.Result:According to TOAST types,there were 39 cases of large artery atherosclerosis (LAA),6 cases of cardiogenic embolism(CE),18 cases of small artery occlusion(SAO),10 cases of other clear causes(OD) and 83 cases of unknown causes(UND).Logistic regression analysis showed that hypertension, smoking,drinking,dyslipidemia,family history of cerebrovascular disease,high homocysteine and diabetes were the risk factors for cerebral infarction in the youth,OR values were respectively 13.861,25.227,21.462,42.653, 42.672,15.282 and 6.491.The risk factors constituent ratio in which hypertension,smoking and drinking were relatively high proportion,followed by 41.1%,42.3% and 41.0%,the lowest proportion of diabetes was 26.3%. Conclusion:The causes of youth cerebral infarction constituent ratio in which UND and LAA are relatively high proportion.The hypertension,smoking,drinking,dyslipidemia,family history of cerebrovascular disease,high homocysteine and diabetes are independent risk factors for youth cerebral infarction.%目的：探讨青年脑梗死的病因及危险因素。方法：应用TOAST分型标准对156例青年脑梗死患者进行病因学分型，分析常见的危险因素。结果：本研究患者TOAST分型构成情况为大动脉粥样硬化型（LAA）39例，心源性脑栓塞型（CE）6例，小动脉闭塞型（SAO）18例，其他明确病因型（OD）10例，病因不明型（UND）83例；多因素Logistic回归分析显示：高血压、吸烟、饮酒、血脂异常、脑血管病家族史、高同型半胱氨酸血症和糖尿病是青年脑梗死发病的独立危险因素，其OR值分别为13.861、25.227、21.462、42.653、42.672、15.282和6.491；危险因素构成比方面，高血压、吸烟、饮酒所占比例相对较高，分别为41.1%、42.3%和41.0%，糖尿病所占比例最低为26.3%。结论：青年脑梗死以OD和LAA所占比例较高，高血压、吸烟、饮酒、血脂异常、脑血管病家族史、高同型半胱氨酸血症、糖尿病为青年脑梗死的独立危险因素。