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目的探讨青年脑梗死的危险因素及头颈CTA的血管情况,为青年脑梗死的治疗及二级预防提供依据。方法分析200例青年脑梗死患者的危险因素及根据中国缺血卒中亚类分型标准(CISS分型)分析各型所占比率,随机抽取同期住院的老年脑梗死患者200例作为对照,分析比较青年组及老年组头颈CTA情况。结果两组在CISS分型上有明显差异,青年组以大动脉粥样硬化型(LAA)比率最高,老年组以穿支动脉疾病(PAD)为主,心源性脑栓塞(CS)在两组之间差异无统计学意义(P>0.05)。高血压、血脂异常、吸烟是青年脑梗死的主要危险因素。青年组共有357处血管狭窄或闭塞,前3个好发部位依次为大脑中动脉、颈内动脉起始段及椎动脉开口;老年组共有466处血管狭窄或闭塞,前3个好发部位为颈内动脉起始段、椎动脉开口及大脑中动脉。结论青年脑梗死以大动脉粥样硬化型为主,头颈CTA结果显示多数为颅内血管病变,大脑中动脉为最常见的好发部位。高血压、血脂异常、吸烟是青年脑梗死的主要危险因素,应尽早发现、及时治疗,做好二级预防。
Objective To investigate the risk factors of cerebral infarction in young people and the vascular conditions of CTA in the head and neck, so as to provide evidence for the treatment and secondary prevention of cerebral infarction in young people. Methods The risk factors of 200 young patients with cerebral infarction were analyzed and the proportion of each type was analyzed according to the Chinese Sub-category of Ischemic Stroke (CISS). 200 elderly patients with cerebral infarction were randomly selected as the control Head and neck CTA in youth group and elderly group. Results There was a significant difference in the CISS classification between the two groups. The youth group had the highest rate of atherosclerosis (LAA), the elderly group was mainly perforating artery disease (PAD), the cardiogenic cerebral embolism (CS) The difference was not statistically significant (P> 0.05). Hypertension, dyslipidemia, smoking are the major risk factors for young cerebral infarction. A total of 357 young patients with vascular stenosis or occlusion, the first three major sites followed by the middle cerebral artery, the initial section of the internal carotid artery and the opening of the vertebral artery; a total of 466 elderly patients with vascular stenosis or occlusion, the first three sites were The beginning of the internal carotid artery, vertebral artery openings and the middle cerebral artery. Conclusion The majority of young patients with cerebral infarction with atherosclerosis type CTA head and neck results show that the majority of intracranial vascular lesions, the middle cerebral artery is the most common sites of predilection. Hypertension, dyslipidemia and smoking are the main risk factors of cerebral infarction in young people. Early detection and timely treatment should be done to prevent secondary prevention.