本文關(guān)鍵詞： 青年 急性腦梗死 TOAST分型 危險因素　出處：《南華大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：青年腦梗死是指18到45歲的腦梗死，通過觀察99例青年急性腦梗死，探討青年腦梗死的主要危險因素及其特點，以達到早期干預，早期發(fā)現(xiàn)，，早期預防，減少發(fā)病率和降低致殘率的目的。 方法：分析2011年10月-2013年10月我院神經(jīng)內(nèi)科18-45歲的急性腦梗死住院患者99例，入院后全部經(jīng)我院的頭顱CT或MRI證實，完善相關(guān)實驗室檢查，進行血管評估，并采用TOAST病因分型分析青年腦梗死的病因及危險因素。 結(jié)果： （1）青年腦梗死發(fā)病率占同期所有腦梗死患者的4.38%，青年男女發(fā)病性別構(gòu)成比為2∶1，青年腦梗死發(fā)病率還與人口分布、工作壓力等相關(guān)。 （2）隨著年齡的增長，青年腦梗死發(fā)病率明顯增加，其中36-45歲發(fā)病人數(shù)占青年腦梗死總?cè)藬?shù)的67.68%。 （3）青年TOAST病因分型所占比由高至低依次為：小動脈閉塞型（SAD）34例（34.34%）、大動脈粥樣硬化型（LAA）27例（27.27%）、心源性栓塞型（CE）21例（21.21%）、其他明確病因型（SOE）12例（12.12%）和不明原因型（SUE）5例（5.05%）。 （4）不同青年腦梗死分型中血清hsCRP、IL-1以及IL-6水平增高程度，LAA型中各指標增高程度明顯高于其它亞型（P＜0.05）。 （5）青年腦梗死最常見的獨立危險因素依次是：高脂血癥（52.53%）、高Hcy血癥（49.49%）、高血壓（46.46%）、糖尿�。�27.27%）、吸煙（21.21%）以及飲酒（20.20%）。 結(jié)論： （1）青年腦梗死最常見的TOAST分型是小動脈閉塞型（SAD）、大動脈粥樣硬化型（LAA）及心源性栓塞型（CE）。 （2）炎癥反應在大動脈粥樣硬化型（LAA）青年腦梗死的發(fā)病中起了一定的作用。 （3）高血壓、糖尿病、高脂血癥、高Hcy、吸煙、飲酒是青年腦梗死的重要獨立危險因素。
[Abstract]:Objective: young cerebral infarction refers to cerebral infarction between 18 and 45 years old. By observing 99 young patients with acute cerebral infarction, the main risk factors and characteristics of young cerebral infarction were discussed in order to achieve early intervention, early detection and early prevention. The purpose of reducing morbidity and disability rates. Methods: a total of 99 patients with acute cerebral infarction aged 18-45 years from October 2011 to October 2013 in our department of neurology were analyzed. All of them were confirmed by CT or MRI in our hospital. The etiology and risk factors of young cerebral infarction were analyzed by TOAST etiological classification. Results:. 1) the incidence rate of young cerebral infarction was 4.38% of all the patients with cerebral infarction in the same period. The sex ratio of young men and women was 2: 1. The incidence rate of young cerebral infarction was also related to population distribution, work pressure and so on. 2) with the increase of age, the incidence of cerebral infarction in young people increased obviously, and the number of young people aged 36 to 45 years old accounted for 67.68% of the total number of young cerebral infarction. (3) the proportion of etiological classification of young TOAST from high to low was as follows: 34 cases of arteriolar occlusive type, 27 cases of large artery atherosclerosis, 21 cases of cardiogenic embolism and 21 cases of cardiac embolism, 12 cases of other definite etiology type, and 5 cases of unexplained type of TOAST, and 5 cases of unexplained type, 5 cases and 5.05%, respectively, of the etiological classification of TOAST in young patients were as follows: 34 cases of arteriolar occlusive type, 27 cases of large artery atherosclerotic type, 21 cases of cardiac embolism type, 12 cases of other definite etiology type, and 5 cases of unknown cause type, respectively. (4) the levels of serum hsCRPP-IL-1 and IL-6 in different young patients with cerebral infarction were significantly higher than those in other subtypes (P < 0.05). (5) the most common independent risk factors for young cerebral infarction were: hyperlipidemia 52.53, hyperlipidemia 49.49, hypertension 46.46, diabetes 27.27m, smoking 21.21) and drinking 20.20%. Conclusion:. The most common TOAST classification of cerebral infarction in young patients was arteriolar occlusive type (SAD), arteriosclerotic type (LAA) and cardiogenic embolization type (CEE). Inflammatory reaction plays a role in the pathogenesis of cerebral infarction in young patients with atherosclerotic arteriosclerosis. 3) Hypertension, diabetes, hyperlipidemia, hyperHcy, smoking and drinking are important independent risk factors for cerebral infarction in young people.
【學位授予單位】：南華大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R743.3

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本文編號：1528452