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目的探讨青年缺血性脑卒中的TOAST分型特点及危险因素,为青年缺血性脑卒中的防治提供依据。方法对64例青年缺血性脑卒中患者及对照组150例中老年缺血性脑卒中患者的TOAST分型及危险因素进行回顾性分析。结果青年组TOAST分型为大动脉粥样硬化型43.8%(28/64),小动脉闭塞型15.6%(10/64),心源性脑栓塞型3.1%(2/64),其他原因型25.0%(16/64),原因不明型12.5%(8/64)。中老年组TOAST分型为大动脉粥样硬化型44.0%(66/150)、小动脉闭塞型30.0%(45/150)、心源性脑栓塞型8.0%(12/150)、其他原因型4.0%(6/150)、原因不明型14.0%(21/150)。TOAST分型两组比较差异明显(P<0.05),青年组其他原因型明显高于中老年组(P<0.05),青年组小动脉闭塞型明显低于中老年组(P<0.05)。两组高血压病、高脂血症、吸烟史、酗酒史等危险因素差异不明显(P>0.05);青年组在脑动脉夹层、烟雾病等方面明显高于中老年组(P<0.05);中老年组在糖尿病史、脑卒中史、男性比率方面明显高于青年组(P<0.05)。结论青年缺血性脑卒中TOAST分型及危险因素不同于中老年缺血性脑卒中,既要重视动脉粥样硬化的防治,更要关注相对少见的病因及危险因素。
Objective To investigate the characteristics and risk factors of TOAST classification in young patients with ischemic stroke and provide evidence for the prevention and treatment of youth ischemic stroke. Methods The TOAST classification and risk factors of 150 elderly patients with ischemic stroke in 64 ischemic stroke patients and controls were retrospectively analyzed. Results There were 43.8% (28/64) cases of atherosclerosis, 15.6% (10/64) cases of arteriole occlusion, 3.1% (2/64) cases of cardioembolism, and 25.0 cases of other causes % (16/64), unexplained 12.5% (8/64). The TOAST classification of the middle-aged and elderly patients was 44.0% (66/150) with atherosclerosis, 30.0% (45/150) with arteriole occlusion, 8.0% (12/150) with cardioembolism, 4.0 % (6/150), unexplained 14.0% (21/150). The TOAST classification showed significant difference between the two groups (P <0.05). The other causes in the youth group were significantly higher than those in the middle aged group (P <0.05). The occlusion of arterioles in the young group was significantly lower than that in the middle aged group (P <0.05). The risk factors such as hypertension, hyperlipidemia, smoking history and alcohol abuse history were not significantly different between the two groups (P> 0.05). The youth group was significantly higher than the middle-aged and elderly patients in terms of cerebral artery dissection and moyamoya disease (P <0.05) The middle-aged and elderly patients were significantly higher than the youth group in the history of diabetes mellitus, the history of stroke and the male ratio (P <0.05). Conclusion TOAST classification and risk factors of young ischemic stroke are different from those of middle-aged and elderly patients with ischemic stroke. It is necessary to pay attention to the prevention and treatment of atherosclerosis, but pay more attention to the relatively rare etiology and risk factors.