| Objective: To analyze the incidence,distribution,related risk factors and etiology of cerebral artery stenosis in youth ischemic stroke.Methods: A total of 375 ischemic stroke patients were enrolled from Department of neurology in the First Affiliated Hospital of Southwest medical university from 2009.1 to 2014.12 retrospectively.they were divided into either a youth group(18 ~ 45 years,n=124)or an elderly group(≥ 45 years,n=251),to discuss the distribution characteristics,related risk factors and etiology of youth ischemic stroke by comparing the distribution condition of cerebral artery in the two groups.Results:(1)There was no statistical significance when comparing the incidence of cerebral artery stenosis in youth group to elderly group(71.8%,(89/124)vs.69.2%,(175/251));In youth group,the incidences of artery stenosis with mild stenosis,moderate stenosis,severe stenosis and occlusion were 14.6%,21.3%,21.3%,42.7% respectively,and they were 15.4%,22.9%,30.9%,30.9% in elderly group,there was no significant differences in the two group(P>0.05).(2)In youth group,the ratio of intracranial artery stenosis was 74.2%(66/89),extracranial artery stenosis was 14.6%(13/89),both intracranial and extracranial artery stenosis was 11.2%(10/89),compared to43.4%(76/175),29.7%(52/175),26.9%(47/175)respectively in elderly group,the artery distribution condition of the two groups was significantly different(P<0.05).(3)The incidences of artery stenosis in anterior circulation,posterior circulation,anterior-posterior circulation were 70.8%(63/89),19.1%(17/89),10.1%(9/89)respectively in youth group,while they were 62.3%(109/175),13.7%(24/175),24%(42/175)in elderly group(P<0.05).(4)The incidences of lesions at single vessel,doublevessel,triple-vessel,more than triple-vessel were 79.8%(71/89),11.2%(10/89),6.7%(6/89),2.2%(2/89)respectively in youth group,while they were 52.6%(92/175),31.4%(55/175),8.0%(14/175),8.0%(14/175)in elderly group,there was significant difference in the number of vessel involved between the twp groups(P<0.05).(5)Angiostenosis involved 90 intracranial arteries and 30 extracranial arteries in youth group,162 intracranial and 141 extracranial arteries in elderly group,the middle cerebral artery was the largest partition in intracranial arteries cases,while extracranial internal carotid artery and extracranial vertebra arteries were the largest partitions in extracranial arteries cases in the two groups;The ratio of middle cerebral artery stenosis in youth group was higher than that in elderly group(42.2%(38/90)vs.38.3%(62/162));There was no statistical differences in the distribution condition of cerebral artery stenosis in the two groups(P>0.05).(6)The proportions of stenosis combined with diabetes,hypertension,and coronary heart disease in elderly group were higher than those in youth group(P <0.05)(32%(56/175)vs.10.1%(9/89),80%(140/175)vs.56.2%(50/89),10.3%(18/175)vs.1.1%(1/89));The proportions of other traditional risk factors involved obesity,smoking,drinking,family history of stoke and hyperuricemia in elderly group were also higher than those in youth group(P>0.05),while the proportion of hyperlipemia in youth group was higher than that in elderly group(P>0.05).Correlation analysis indicated that cerebral artery stenosis related to age,smoking and hypertension,which correlated with age(OR=1.018,95.0%CI=1.000-1.035,P=0.003 and hypertension(OR=2.179,95.0%CI=1.393-3.410,P=0.001)significantly.(7)Atherosclerosis stenosis was the most common etiology type in the two groups,it counted for 52.8%(47/89)in youth group and 88.6%(155/175)in elderly group(P < 0.05);The proportions of nonatherosclerosis stenosis and undetermined cause stenosis in youth group were higher than those in elderly group(30.3%(27/89)vs.7.4%(13/175),16.9%(15/89)vs.4%(7/175))(P<0.05);Arteriovenous malformation was the most common type in non-atherosclerosis stenosis cases,followed by moyamoya disease,aortic dissection and vasculitis.Conclusion:(1)Cerebral artery stenosis was common in youth ischemic stroke patients,in which vascular occlusion was the most common type.(2)It primarily affected single intracranial artery,single extracranial artery steosis and both intracranial and extracranial artery stenosis also counted for a certain proportion.(3)It primarily affected anterior circulation artery.(4)A single vessel lesion was the most common type in youth stroke patients,followed by double-vessel lesion,triple-vessel lesion,and more than triplevessel lesion.(5)The middle cerebral artery was the largest partition in intracranial arteries stenosis cases,while extracranial internal carotid artery and extracranial vertebra arteries were the largest partitions in extracranial arteries stenosis cases.(6)Artery stenosis combined with hyperlipemia accounted for the largest percentage,followed by hypertension,smoking,drinking,obesity,diabetes mellitus,family history of stroke,hyperuricemia and coronary heart disease;Cerebral artery stenosis was related to age,smoking,and hypertension,and which was correlated to age and hypertension significantly.(7)The most common type of cerebral artery stenosis was atherosclerosis stenosis,while non-atherosclerosis stenosis and undetermined cause stenosis accounted for a certain proportion;Nonatherosclerosis stenosis cases involved arteriovenous malformation,moyamoya disease,aortic dissection and vasculitis. |
PDF Full Text Request