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目的探讨青年脑卒中的危险因素以及临床特点。方法 2006年1月至2009年12月共收治青年脑卒中62例(青年组),随机选择同期收治的152例脑卒中中的70例老年患者(老年组)做比较。所有患者均检查心电图、X线胸部正侧位片、血糖(空腹及餐后2h)、血脂、肝肾功能、凝血四项,行心脏超声及颈部动脉血管超声(包括颈动脉和椎动脉)检查,对患者的血管进行超声评价,同时对危险因素包括高血压、糖尿病、血脂异常、吸烟、酗酒等病史,既往有无心脑血管病史及早发家族性心脑血管病史进行调查。结果 62例青年脑卒中患者中90.3%为男性,其中87.1%为缺血性脑卒中,且64.5%为腔隙性脑梗死,48.4%的青年卒中患者存在颈动脉和/或椎动脉的粥样硬化或狭窄,71.0%患者有早发家族心血管病史,56.5%有高血压病史,40.3%患者有家族性高血压病史,35.5%有吸烟史,16.1%有酗酒史。结论青年脑卒中患者中男性多见,且以腔隙性脑梗死多见,早发性动脉粥样硬化是青年脑卒中的发病原因,危险因素主要有早发家族性心血管病史、高血压病史、家族高血压病史、吸烟史及酗酒史。早期控制危险因素可以减少青年脑卒中的发生。
Objective To explore the risk factors and clinical features of young stroke. Methods From January 2006 to December 2009, 62 young stroke patients (youth group) were enrolled. A total of 152 elderly patients (aged group) were enrolled in this study. All patients were examined electrocardiogram, chest X-ray film is lateral, blood glucose (fasting and postprandial 2h), lipids, liver and kidney function, coagulation four, line of cardiac ultrasound and neck artery ultrasound (including the carotid and vertebral arteries) Check, the patient’s blood vessels for ultrasound evaluation, at the same time, risk factors including hypertension, diabetes, dyslipidemia, smoking, alcoholism and other medical history, previous cardiovascular disease history and early onset of familial cardiovascular disease history investigation. Results Of the 62 young stroke patients, 90.3% were male, of whom 87.1% were ischemic stroke and 64.5% were lacunar infarction. 48.4% of young stroke patients had atherosclerosis and / or vertebral artery atherosclerosis Sclerosis or stenosis, 71.0% of patients had a history of early family history of cardiovascular disease, 56.5% had a history of hypertension, 40.3% had a history of familial hypertension, 35.5% had a history of smoking, and 16.1% had a history of alcoholism. Conclusion Young men are more common in stroke patients and more often seen in patients with lacunar infarction. Early-onset atherosclerosis is the causative factor of youth stroke. The risk factors include early onset of familial cardiovascular disease, history of hypertension , Family history of hypertension, smoking history and history of alcohol abuse. Early control of risk factors can reduce the incidence of stroke in young people.