162例青年脑梗死患者病因分型、危险因素及预后分析

摘要

目的：探讨青年脑梗死的病因分型、危险因素及预后。方法回顾性分析162例急性青年脑梗死患者的临床资料，采用 Logistic 回归分析其主要危险因素。结果本组患者病因分型构成为大动脉粥样硬化型38例（占23．5％），心源性型20例（占12．3％），小动脉病变型28例（占17．3％），其他原因型12例（占7．4％），原因不明型64例（占39．5％）。可能的危险因素所占构成比为：高血压病51．2％（83／162）、吸烟34．6％（56／162），高脂血症28．4％（46／162），饮酒25．3％（41／162），心脏疾病13．6％（22／162），糖尿病11．1％（18／162）。 Logistic 回归分析提示高血压、吸烟、高脂血症、饮酒是青年脑梗死的危险因素。162例患者中81例完全恢复，56例遗留较轻的后遗症，22例遗留严重后遗症，3例急性期死亡。结论青年脑梗死的病因分型以原因不明型和大动脉粥样硬化性型所占比例较高。危险因素为高血压病、吸烟、高脂血症和饮酒。%Objective To analyze the etiology,risk factors and prognosis in young patients with cerebral infarction .Methods Clinical data of 162 young patients at the first attack of acute cerebral infarction were analyzed .Logistic regression analysis was used to analyze the major risk factors.Results According to TOAST typing,there were 38 cases with large artery atherosclerotic infarction (23.5%),28 with small artery cerebral infarction (17.3%),20 with cardiogenic cerebral embolism (12.3%),12 with cerebral infarc-tion of other causes (7.4%) and 64 with unknown origin (39.5%).The possible risk factors were hypertension (83 /162 cases, 51.2%),smoking (56 /162 cases,34.6%),blood lipid abnormality(46 /162 cases 28.4%) and alcohol consumption (41 /162 cases, 25.3%),heart disease (22 cases,13.6%) and diabetes mellitus (18 /162 cases,11.1%).Logistic regression analysis showed that hypertension,smoking,blood lipid abnormality and alcohol consumption were the risk factors of the disease .In these patients,81 cases were recovered completely,56 cases had mild sequelae,22 cases had serious sequelae and 3 cases dead during the acute phase .Con-clusion The unknown causes and large artery atherosclerotic cerebral infarction are the most common etiological types in young adults with cerebral infarction.The risk factors are hypertension,smoking,blood lipid abnormality and alcohol consumption .