| Objective: We summarized the characteristics of ischemic stroke in young patients by analyzing the risk factors and etiology of ischemic stroke in youth,and established the risk prediction model in order to provide clinical theoretical support for the prevention of ischemic stroke in young patients.Method : We collected 290 young patients(18-45 years old)who were firstly diagnosed with ischemic stroke in the Hospital from 2012 to 2020,and assigned them as the experimental group.Then,we divided the experimental group into three subgroups according to age: A,B and C(A:18-25 years old,B:26-35 years old,C:36-45 years old).At the same time,272 non-young patients with ischemic stroke(> 45 years old)during this period were collected,and they were set as control group 1;A total of 236 young patients(18-45 years old)with non-ischemic stroke during this period were collected,and they were set as control group 2.By analyzing the characteristics of young patients with cerebral infarction,we can establish the a risk prediction model of young patients with ischemic stroke.Results:(1)General situation analysis:In the young group of ischemic stroke patients,the males’ component ratio was 86.2%,and the females’ component ratio was 13.8%(P< 0.05),and in middle-aged and elderly patients,male accounted for 66.2%,female accounted for 33.8%,we found the males’ component ratio was higher than that of female in both groups(P<0.05);Among young patients,the average age of male was39.520±5.2291 years old,and the average age of female was 38.500±7.3902 years oldthe,so,we found the average age of male patients was higher than female patients(P < 0.05);Among the young subgroups,the number of patients(36-45 years old)were much higher than that of other groups(P < 0.05).(2)The main risk factors of young patients with ischemic stroke were hypertension(47.9%),smoking(47.6%),hyperlipidemia(45.5%),high homocysteine(32.8%),drinking alcohol(19.7%),diabetes(19.0%),hyperuricemia(16.2%),obesity(16.2%),et al.Among young patients,the exposure rate of smoking,hyperlipidemia,hyperhomocysteine and alcohol consumption in male patients was higher than that in female patients(P < 0.05).The main risk factors of middle-aged and elderly patients with ischemic stroke were hyperhypertension(70.6%),hyperlipidemia(50.7%),hyperhomocysteine(32.7%),diabetes(30.9%),smoking(29%),drinking alcohol(22.4%),history of heart disease(16.2%)and hyperuricemia(14.7%).Compared with middle-aged and elderly patients,the exposure rate of smoking in young patients was higher,while the exposure rate of hypertension and coagulation dysfunction was lower than that in middle-aged and elderly patients(P < 0.05).The analysis of three subgroups A,B and C of young patients showed that smoking,diabetes,hyperuric acid and cerebrovascular malformations were more common in group C,hyperbilirubin was more common in group B,and autoallergic reactions were mainly found in group A and group B(P <0.05).(3)Etiological analysis:According to TOAST classification,the main type of young patients was large-artery atherosclerosis(43.8%),followed by unidentified type(21.7%)and arteriole embolism type(18.6%).The cardiac embolism and other causes are rare.Compared with middle-aged and elderly patients,the proportion of cerebral infarction of other causes and unknown causes in young patients was higher(P < 0.05).Compared with each subgroup of young patients,only the distribution of arteriole embolization was different among each group,most of which occurred in patients aged36-45 years(P < 0.05).(4)Analysis of risk factors for different TOAST subtypes: In young ischemic stroke patients with large atherosclerotic type,hypertension,smoking,hyperlipidemia and diabetes were more common;high total bilirubinemia was more common in the type with unknown causes;heart disease was more common in cardiogenic embolism;and cerebrovascular malformation was more common in other causes(P < 0.05).(5)The univariate and multivariate analysis of risk factors in young patients showed that some factors were significantly correlated with ischemic stroke in young patients(P < 0.05),such as age,gender,hypertension,smoking,high homocysteine,alcohol consumption,diabetes.Males,smoking,hypertension and diabetes were independent risk factors for ischemic stroke in young people,and smoking was the largest risk factor.The risk prediction model of ischemic stroke in young people: Logit(P)=-2.465 +0.717* sex(male =1,female =0)+1.192* smoking(exist =1,none =0)+1.127* hypertension(exist =1,none =0)+0.661* diabetes(exist =1,none =0),P=0.000 < 0.001.The sensitivity and specificity of the prediction model were72.8% and 70.3%,and the model was statistically significant.Conclusion :(1)There were more males than females in young ischemic stroke,and the average age of males was higher than that of females.(2)Most patients of young ischemic stroke are 36 to 45 years old.(3)The most relevant risk factors for young patients are hypertension,smoking,hyperlipidemia,hyperhomocysteine,alcohol consumption,diabetes,obesity and hyperuricemia.Among those factors,smoking,hypertension and diabetes are independent risk factors,and the smoking is the largest risk factor,so we should take active intervention.(4)The main etiology type of young patients is large-artery atherosclerosis,which is closely related to hypertension,smoking,hyperlipidemia and diabetes,so we should take active intervention.(5)The etiology of young patients is complex,the number of its other etiology and undetermined etiology were far more than middle-aged and elderly patients.(6)We will filtrate high-risk patients through risk prediction model,Guiding them to form healthy lifestyle and habits,which can reduce the prevalence rate of ischemic stroke in young people. |
PDF Full Text Request