| Objectives:1.to investigate the distribution of TOAST etiology in patients with ischemic stroke(ischemic stroke,IS)in our nosodochium.2.to study the relationship between TOAST and related factors in young IS patients,and to chase down the potential risk factors,as well as to provide the basis for clinical diagnosis and treatment of young patients with IS.Methods:Using the method of retrospective study,from January 2014 to July 2016 in the first seizure for the General Hospital of Ningxia Medical University 18-45 young IS patients in175 cases,among them,132 were male,43 were female,were all confirmed by head CT or MRI examination,and record the general clinical data of patients were amassed,lab test,imaging examination etc.of all the diagnosis indicators.The patients were selected according to the TOAST classification criteria for classification.Etiology and subgroup analysis of risk factors,and to analyze the impact of different risk factors on the risk of each subtype of IS by statistics.Results:1.Distribution characteristics of TOAST:typing 175 patients,among the 22 Hui ethnic groups,153 were in the local population,64 were in the surrounding areas,and the 89 were in the surrounding areasmale 132 cases,female 43 cases,female :male was 1:3,the mean age was 38.33±6.12 years.Large artery atherosclerosis(LAA)in 53 cases(30.3%,53/175)is IS TOAST youth causes the most common subtypes.Followed by SAO or lacunar stroke(47 cases26.9%,47/175),24 cases of CE(13.7%,24/175);16 cases of ODE(9.1%,16/175),the internal carotid artery dissection,And more than 35 years old of high-risk females with CE 5cases,there were rheumatic heart disease with atrial fibrillation in 3 cases,1cases of everlasting atrial fibrillation,1 cases of left atrial gelatinous tumor,infectious endocarditis complicatedwith P2 vegetations in 1 cases,under 35 years old of 1 patients with discontinuous atrial fibrillation.(2)smoking in 87 cases(49.7%,87/175),and were male.(3)hyperlipidemia in 79cases(45.1%,79/175),of which high glycerin three greases in 61 cases(34.9%,61/175),hypercholesterolemia in 6 cases(3.4%,6/175),both have increased in 12 cases(6.9%,12/175).(4)hypertension in 72 cases(41.1%,72/175),including 59 cases of male hypertension,(33.7%,59/175),female 13 cases of hypertension(7.4%,13/175).(5)there were 54 cases of alcohol(30.9%,54/175),and were men.3.the variable factors in the comparison of various subtypes:(1)the comparison of the different gender: the most common youth IS to LAA,which there was no statistical significance in the proportion of men and women(X2=1.334,P=0.248);more men in the SAO of statistical difference(X2=4.832,P=0.028);CE in women is more common,the difference was statistically significant(X2=4.386,P=0.036);CEwith the risk of cerebral embolism no significant difference in the comparison of indexing IS gender in youth(Fisher’s exact value is 0.697),but more than 35 years old in a higher proportion of women had no significant difference Significance(Fisher’s exact value is 0.266),and over 35 high risk women with CE in 5 cases,including 3 cases of rheumatic heart disease: for atrial fibrillation,1cases of permanent atrial fibrillation,1 cases of left atrial myxoma,1 cases of infective endocarditis complicated with mitral valve area P2 excrescence,35 women under the age of 1patients with paroxysmal atrial fibrillation.(2)comparison of different age groups: 36-45 years old young IS in high incidence(69.1%,121/175),TOAST subtypes in different age groups which have difference,the higher the proportion of patients aged 18-35 in CE,the difference was statistically significant(X2=7.083,P=0.008),the other types were not statistically significant(P >0.05).(3)comparison of different nationalities: there was not statistically significant in the ratio of middle and back to Han in each subtype(P>0.05)4.the variable risk factors in different subtypes : All the TOAST subtypes of hypertension,hyperlipidemia,smoking rate distribution is different,there was not statistically significant(P<0.05),and hyperhomocystinemia,DM,there is not statistically significant in the distributing of alcoholbetween various types of(P>0.05).LAA in hyperlipidemia,smoking a higher proportion of patients,with statistically significant(P<0.05)a higher scale of suffereres with hypert;in SAO,there was statistical significance(P<0.05).5.Compared with infarction sites in different subtypes:124 cases were anterior circulation(70.9%),and the other was posterior circulation(28.6%).There were no significant differences in the anterior circulation of IS in young sufferers;There was not significantly different in TOAST subtype between the anterior and posterior circulation(P>0.05).Conclusions: 1.TOAST subtypes of etiological type LAA in the most common,followed by SAO;2.HHcy level in the IS youth risk factors than in the highest proportion,should actively intervene;3.SAO male more common,more common in women with type CE,3 cases and 35 years of high risk CE rheumatic heart disease with atrial fibrillation(60%,3/5),suggesting that CE of high risk women with intervention and more attention should be paid.4.LAA in hyperlipidemia,smoking a higher proportion of patients,a higher proportion of patients with hypertension in SAO;different risk factors may increase the incidence of different subtypes of IS. |
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