青年卒中危险因素及其临床特点分析
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摘要
脑卒中(别名脑中风),又称脑血管意外。是一种突发的脑血液循环障碍导致颅内缺血或出血性疾病,各种诱因导致脑内动脉狭窄,闭塞或破裂,造成急性脑血液循环障碍,以一过性或永久性神经功能缺失为临床症状和体征。青年脑卒中定义是:年龄不超过45岁的成年人发生脑血管意外(缺血性和出血性卒中),占全部卒中的5%～15%。
随着慢性病发病年龄的提前和人口老龄化趋势加速,中国脑卒中的防控形势将更加严峻,脑卒中的发病年轻化趋势,因此关于青年脑卒中的研究日益受到关注。世界卫生组织最新数据表明,全球每6个人中就有1人可能罹患卒中,每6秒就有1人死于卒中。卒中发病年轻化的危害性日益突出,因此关于青年脑卒中的研究受到社会各界广泛重视。近年来大量学者致力于青年卒中的研究,其发病率、致残率、致死率逐年增高,严重影响人们的生活质量,威胁生命安全,给患者和家属带来巨大痛苦,亦给国家和社会造成严重经济负担。
本研究收集以吉林大学第一医院神经科入院诊断为脑卒中的患者,其中选取出生于1966年1月1日至2011年5月1日年龄在45岁以下包括45岁的青年脑卒中患者366例,选取出生于1856年1月1日至1951年12月31日年龄在60岁以上包括60岁的老年脑卒中患者215例,并选取同期青年对照共95例。采用SPSS15.0统计学分析,描述青年脑卒中的基本现状,对其危险因素进行探讨。
我们研究发现,青年脑卒中患者主要集中在31岁～45岁这个年龄段,男性多于女性,缺血性卒中多于出血性卒中;青年卒中患者与老年卒中患者相比,病变部位多位于右侧,且幕上病变多于幕下;与老年脑卒中患者相,青年组脑卒中患者受心脏病、高血压的影响较小,同时脑卒中发病史不明显。与青年对照组比较,青年脑卒中病例组既往脑卒中病史高于对照组。糖尿病史、高血压史、血脂异常史、实验室检查:TG(甘油三酯) >1.70mmol/L、LDL-C(低密度脂蛋白)>3.12 mmol/L的患病率高于对照组。同时在青年脑卒中病例组中吸烟、饮酒的比例也明显高于对照组。通过以上研究表明年龄、性别、糖尿病、高血压、血脂异常、TG(甘油三酯) >1.70mmol/L、LDL-C低密度脂蛋白)>3.12 mmol/L、吸烟、饮酒的是青年脑卒中的危险因素;青年脑卒中的危险因素依次为年龄(疾病有明显的好发年龄段)、性别(男性患者多于女性),血脂异常、高血压、吸烟、饮酒、糖尿病。而老年卒中患者的危险因素依次为性别、血脂异常、颈内动脉斑块形成、高血压、既往卒中病史、吸烟、心脏病、糖尿病、饮酒。研究证实二者之间存在差异,可应用于指导临床预防及治疗。
Stroke, also known as stroke, is a sudden onset of cerebral blood circulation disorders, also known as cerebrovascular accident.It refers to patients with cere brovascular disease, causing by various factors incuding brain artery stenosis, occlusion or rupture and leading to acute cerebral blood circulation disorders.The tipical symptom and sign of this disease are transient or permanent brain dysfunction .It can be divided into ischemic stroke and hemorrhagic stroke. Stroke among young people refers to that of the ones under the age of 45 ,accouting for 5%~15% of this disease.
With the chronic diseases breaking out in advance and acceleration of aging population,the prevention and control of stroke will face a severe situation in china. Latest WHO data shows that one in every six people may suffer from the stroke, one person dies and another one is disabled due to stroke per six seconds. The majority of the patients become disabled,such as hemiplegia , aphasia, and blindness. The incidence of stroke in china is four or five times higher than that in Eropean countries, 3.5 times than that in Japan. There's an increasingly danger of young people's suffering from stroke , and thus,gaining more and more attention. In recent years, reports on young stroke have gradually increased and the incidence rate is also on a rise. It has seriously affected the patient's living and working quality, bringing not only mental stress to patients, but also economic burden to families and the society.
Selecting,from the neurology department in the first hospital of Jilin University ,366 cases of patients being disanosed as stroke of an age under 45 from January 1, 1966 to May 1, 2011 , and 215 from January 1, 1856 to December 31, 1951 of an age above 60 ,compare to 95 young stroke patients at that time in the same hospital. Describing the basic status and risk factors for stroke of young people by spss analysis.
Mainly in young stroke patients aged 31 to 40 years old and two41-year-old age 45, male patients than female, more cerebral hemorrhage cerebral infarction, hospital-based diagnostics to 5.Compared with elderly stroke patients, stroke patients affected bychronic youth group was less affected, while the incidence of stroke history was not obvious. Compared with young controlgroup, youth group of stroke patients past history of stroke in patients. The results showed that diabetes, hypertension, dyslipidemia, smoking and drinking may be a risk factor for stroke in young people.
随着慢性病发病年龄的提前和人口老龄化趋势加速,中国脑卒中的防控形势将更加严峻,脑卒中的发病年轻化趋势,因此关于青年脑卒中的研究日益受到关注。世界卫生组织最新数据表明,全球每6个人中就有1人可能罹患卒中,每6秒就有1人死于卒中。卒中发病年轻化的危害性日益突出,因此关于青年脑卒中的研究受到社会各界广泛重视。近年来大量学者致力于青年卒中的研究,其发病率、致残率、致死率逐年增高,严重影响人们的生活质量,威胁生命安全,给患者和家属带来巨大痛苦,亦给国家和社会造成严重经济负担。
本研究收集以吉林大学第一医院神经科入院诊断为脑卒中的患者,其中选取出生于1966年1月1日至2011年5月1日年龄在45岁以下包括45岁的青年脑卒中患者366例,选取出生于1856年1月1日至1951年12月31日年龄在60岁以上包括60岁的老年脑卒中患者215例,并选取同期青年对照共95例。采用SPSS15.0统计学分析,描述青年脑卒中的基本现状,对其危险因素进行探讨。
我们研究发现,青年脑卒中患者主要集中在31岁～45岁这个年龄段,男性多于女性,缺血性卒中多于出血性卒中;青年卒中患者与老年卒中患者相比,病变部位多位于右侧,且幕上病变多于幕下;与老年脑卒中患者相,青年组脑卒中患者受心脏病、高血压的影响较小,同时脑卒中发病史不明显。与青年对照组比较,青年脑卒中病例组既往脑卒中病史高于对照组。糖尿病史、高血压史、血脂异常史、实验室检查:TG(甘油三酯) >1.70mmol/L、LDL-C(低密度脂蛋白)>3.12 mmol/L的患病率高于对照组。同时在青年脑卒中病例组中吸烟、饮酒的比例也明显高于对照组。通过以上研究表明年龄、性别、糖尿病、高血压、血脂异常、TG(甘油三酯) >1.70mmol/L、LDL-C低密度脂蛋白)>3.12 mmol/L、吸烟、饮酒的是青年脑卒中的危险因素;青年脑卒中的危险因素依次为年龄(疾病有明显的好发年龄段)、性别(男性患者多于女性),血脂异常、高血压、吸烟、饮酒、糖尿病。而老年卒中患者的危险因素依次为性别、血脂异常、颈内动脉斑块形成、高血压、既往卒中病史、吸烟、心脏病、糖尿病、饮酒。研究证实二者之间存在差异,可应用于指导临床预防及治疗。
Stroke, also known as stroke, is a sudden onset of cerebral blood circulation disorders, also known as cerebrovascular accident.It refers to patients with cere brovascular disease, causing by various factors incuding brain artery stenosis, occlusion or rupture and leading to acute cerebral blood circulation disorders.The tipical symptom and sign of this disease are transient or permanent brain dysfunction .It can be divided into ischemic stroke and hemorrhagic stroke. Stroke among young people refers to that of the ones under the age of 45 ,accouting for 5%~15% of this disease.
With the chronic diseases breaking out in advance and acceleration of aging population,the prevention and control of stroke will face a severe situation in china. Latest WHO data shows that one in every six people may suffer from the stroke, one person dies and another one is disabled due to stroke per six seconds. The majority of the patients become disabled,such as hemiplegia , aphasia, and blindness. The incidence of stroke in china is four or five times higher than that in Eropean countries, 3.5 times than that in Japan. There's an increasingly danger of young people's suffering from stroke , and thus,gaining more and more attention. In recent years, reports on young stroke have gradually increased and the incidence rate is also on a rise. It has seriously affected the patient's living and working quality, bringing not only mental stress to patients, but also economic burden to families and the society.
Selecting,from the neurology department in the first hospital of Jilin University ,366 cases of patients being disanosed as stroke of an age under 45 from January 1, 1966 to May 1, 2011 , and 215 from January 1, 1856 to December 31, 1951 of an age above 60 ,compare to 95 young stroke patients at that time in the same hospital. Describing the basic status and risk factors for stroke of young people by spss analysis.
Mainly in young stroke patients aged 31 to 40 years old and two41-year-old age 45, male patients than female, more cerebral hemorrhage cerebral infarction, hospital-based diagnostics to 5.Compared with elderly stroke patients, stroke patients affected bychronic youth group was less affected, while the incidence of stroke history was not obvious. Compared with young controlgroup, youth group of stroke patients past history of stroke in patients. The results showed that diabetes, hypertension, dyslipidemia, smoking and drinking may be a risk factor for stroke in young people.
引文
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[2] Cushman M ,Cantrell RA,MeClure LA.Estimated 10-year stroke risk by region and race in the United State:geographic and racial difference in stroke risk .[J].Ann Neurol,2008,64(5):507.
[3] Bogousslavssky J, Pierre P. Ischemic stroke in patients under age 45. NeurolClin,1992,10: 113-124.
[4] Steven J, Kittner. Stroke in the young. Neurology, 2002,59(1): 627.
[5]北京神经病学学术沙龙.2359例青年患者脑卒中患者危险因素研究[J].中华流行病学杂志,2003,24(2):106.
[6] Neretin V ,Vostrikova I ,Kotov S.Stroke in young inhabitants of Moscow area [J].Eur J Neurol ,2001,8(2):15
[7]王贞,韩钊,邵蓓,等。温州地区中青年脑卒中个年龄阶段特点及危险因素分析[J。心血管疾病防治。2009,9(4):288.
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