| Objective:In resent years,there is an increasing incidence of ischemiccerebrovascular disease in the patients who are younger than45years old,which caused a great burden to families and society. As a common type ofischemic cerebrovascular disease, transient ischemic attack is considered tobe the most important risk factor, having an intimate connection with cerebralinfarction. The purpose of this study was analyzing common risk factors andcorrelative factors of cerebral infarction, predicting the incidence of cerebralinfarction by "ABCD2" clinical scale and imaging studies such as MRI, DWIand MRA, helping clinician to cure young transient ischemic attack patients.Methods:Collected outpatients and inpatients with transient ischemicattack in department of neurology of second hospital of Hebei medicaluniversity from March2010to December2011, divided them into two agegroups, the younger group patients were between18to44years old, and theolder group patients were more than44years old. Recorded their risk factors,clinical symptoms,imaging results and "ABCD2" score. All patients werefollowed up at7days and90days after TIA, to observe the outcome of thisdisease.The results were analyzed by SPSS13.0statistical software. Comparedthe risk factors, imaging results,"ABCD2" score and the outcome ofdisease between two age groups. The correlation between "ABCD2" score andthe outcome in TIA patients within7days and90days was analyzed by linearregression analysis. The common risk factors and "ABCD2" score risk factorswere analyzed by Logistic regression. P＜0.05was considered statisticallysignificant.Results:1The baseline characteristics of TIA patients: there were148patients in the younger group,101cases were male (68.2%) and47cases were females(31.8%), aging from18to44years old, the mean age was36.5±7.32yearsold.121cases were carotid artery TIA patients (81.7%),27cases werevertebrobasilar TIA patients (18.3%).62cases were inpatients (41.9%)and86cases were outpatients (58.1%).41cases (27.7%) had hypertension,14cases (9.4%) had diabetes,17cases (11.4%) had ischemic heart diseasehistory,10cases (6.7%) had atrial fibrillation history,71cases (47.9%) hadhyperlipidemia,90cases (60.8%) had history of smoking,31cases (20.9%)had history of drinking,21cases (14%) were obesity,19cases (12.8%) hadmigraine history,15cases (10.1%) had obstructive sleep apnea syndrome(OSAS),64cases(43.2%) had cerebrovascular disease family history.There were180patients in the older group,117cases were male(65.0%) and63cases were females (35%), aging from45to88years old, themean age was61.4±9.26years old.91cases were inpatients (50.5%) and89cases were outpatients (49.5%).109cases (60.5%) had hypertension,48cases (26.6%) had diabetes,67cases (37.2%) had ischemic heart diseasehistory,27cases (15.0%) had atrial fibrillation history,39cases (21.6%) hadhyperlipidemi,79cases (43.8%) had history of smoking,19cases (10.5%) hadhistory of drinking,11cases (6.1%) were obesity,18cases (10.0%) hadmigraine history,25cases (13.8%) had obstructive sleep apnea syndrome(OSAS),41cases (22.7%) had cerebrovascular disease family history.2Risk factors:The incidence of smoking, hyperlipidemia, cerebrovasculardisease family history, drinking, obese in the younger group is higher thanthose in the older group; the incidence of hypertension; in the older group, theincidence of hypertension, diabetes, ischemic heart disease history, atrialfibrillation history is higher than the younger group (P＜0.05).3Outcomes:the incidences of cerebral infarction within7days and90days inthe younger group were6.8%and12.8%,lower than the older group (10.5%and20.5%).4The younger group patients with positive result of DWI or MRA had higherincidence of cerebral infarction within7days and90days (P＜0.05),MRI lesions could not predict the occur of cerebral infarction (P＞0.05).5In the younger group, there were133cases with low "ABCD2" score (0-3point),15cases with high "ABCD2" score (4-7point); in the older group,there were104cases with low score, and76cases with high score. Theyounger group had more cases with low "ABCD2" score(P＜0.05). With theincreasing"ABCD2"score,the incidences of cerebral infarction within7daysand90days were rising. The regression analysis of the relationship between"ABCD2" score and cerebral infarction showed that7days regressioncoefficient B=0.832, P=0.020；90days regression coefficient B=0.929,P=0.003. Patients with higher "ABCD2" score had a higher incidence ofcerebral infarction than those with lower score(P＜0.05).6The incidence of cerebral infraction within7days was significantly higherin young TIA patients who had diabetes, duration of symptoms≥10minutes.The incidence of cerebral infraction within90days was significantly higher inyoung TIA patients who had hypertension, diabetes, duration of symptoms≥10minutes.Conclusion:Young TIA patients had all kinds of risk factors, the order ofthese factors was different from old TIA patients. The young patients hadbetter outcomes than the older ones. The main cerebral infarction risk factorsin the young patients within7days were diabetes, duration of symptoms≥10minutes; The main cerebral infarction risk factors in the young patientswithin90days were hypertension, diabetes, duration of symptoms≥10minutes."ABCD2" score,DWI and MRA could predicted the risk of cerebralinfarction in a short term, guiding the clinical treatment. |
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