The Retrospective Analysis And Follow-up Study On The Patients With Cerebral Infarction In Young And Middle Age

Objective: 1.The purpose of the study was to examine the clinical characteristics,etiology and risk factors of cerebral infarction in young and middle-aged adults and to provide a theoretical basis for the primary prevention of high risk population.2.To investigate the situation of the secondary prevention of cerebral infarction and the occurrence of cerebral vascular events in young and middle-aged patients after discharge by telephone.It was also to find out the risk factors of the secondary prevention of cerebral infarction in young and middle-aged patients and to provide the theoretical basis for the the secondary prevention of stroke.Methods: This study retrospectively analyzed the clinical data of patients with cerebral infarction in the department of neurology,the First Affiliated Hospital of Hainan Medical University from January 2015 to December 2015.The clinical data includes gender,age,hypertension,diabetes,heart disease,family history of stroke,smoking history,drinking history,body mass index(BMI),fibrinogen,homocysteinemia,blood lipid level,the features of the carotid artery ultrasonography and cranial MRI.It is to analyze the etiology and risk factors of cerebral infarction in young adults.To investigate the situation of the secondary prevention of cerebral infarction and the occurrence of cerebral vascular events in young and middle-aged patients after discharge in one year by telephone.It is including medication,cerebrovascular events,risk factors modification.Combined with patients’ occupation,education level,living environment,TOAST classification,medical insurance to investigate the situation of the secondary prevention of cerebral infarction and the occurrence of cerebral vascular events in young and middle-aged patients.Statistical analysis was assessed by SPSS20.0 statistical packages,single factor analysis by χ2 or t test,the Logistic multivariate regression analysis model was used to deter-mine the factors that might significantly influence the incidence of stoke in young adults.Results: 1.Retrospective analysis of case data1.1 A total of 275 patients had ischemic strokes in the study,183 men accounted66.5%,92 women accounted 33.5%,55 middle-aged patients accounted 20%,220 older accounted 80%,173 cases with hypertension(62.9%),75 cases with diabetes(27.3%),218 cases with carotid arteriosclerosis(79.3%),103 cases with smorking(37.5%),82 cases with alcohol(29.8%).Dyslipidemia is the most common risk factor,the incidence of cerebral infarction in male is higher than that of female,the incidence of cerebral infarction in middle-aged is significantly higher than that of young people,the difference is significant(P<0.01).1.2 Male smoking rate and drinking rate were significantly higher than that of female,the difference was statistically significant(P<0.01).1.3 The total cholesterol and triglyceride in the youth group were lower than those in the middle-aged group,the difference was statistically significant(P<0.01).1.4 The most common type of TOAST classification was small artery disease,and the stroke of other determined etiology and undetermined etiology in the youth group were significantly higher than those in the middle-aged group.The difference was statistically significant(P<0.05).2.Follow-up study2.1 There were 251 cases(91.3%)were followed successfully,including 23 cases of cerebral vascular events: 2 cases of transient ischemic attack,21 cases of cerebral infarction.There were 7 cases died,including 4 cases due to the cerebral infarction,3cases due to non cerebral vascular events.2.2 The situation of secondary prevention of 55% patients was well.5 cases(3.6%)occurred cerebral vascular events including cerebral infarction.The situation of secondary prevention of 45% patients was poor.18 cases(15.9%)occurred cerebral vascular events including cerebral infarction and TIA.There were 4 cases due to the cerebral infarction.The incidence of cerebral vascular events of good secondary prevention group was significantly lower than the poor secondary prevention group.2.3 The overall reaching of target of non-smoking,no drinking,BP reached target and the blood sugar control reached target in good secondary prevention group was higher than poor secondary prevention group.2.4 The factors influencing secondary prevention were received health education and got chronic medical insurance by multiple regression.Conclusions:1.The etiology and risk factors of young and middle-aged patients with cerebral infarction was complicated,the atherosclerosis was the main cause.The SUE and SOE were more in the young patients than middle-aged patients.The most common risk factor for young and middle-aged patients is the disorder of lipid metabolism.With the increase of age,the proportion of hypertension and diabetes increased.Accordingly,it is an important strategy to reduce the incidence of cerebral infarction by strengthening the propaganda of primary prevention to control the risk factors in young and middle-aged patients.2.There was a big gap between the current situation and prevention guidelines in young cerebral infarction patients.Health education and application of the chronic health insurance were independent predictors of the secondary prevention.Good secondary prevention can reduce the incidence of cerebral vascular events in young and middle-aged patients.