| Objective:Ischemic stroke is serious threat to people’s health, and the patients are getting younger and younger in recent years. Incidence of ischemic stroke in young adults is gradually increasing, seriously affecting on young people’s work and life. Relative to the elderly, young stroke brings more heavy economic burden to the society and family. Therefore, it is very important to the prevention and treatment of ischemic stroke in youth. This study analyzed the clinical features of the different age groups of young patients with ischemic stroke common risk factors, etiology, and cerebral vascular imaging, and compared with previous similar studies to investigate the possible pathogenesis of young ischemic stroke.Method:96cases of patients with diagnosis and treatment consisted of young stroke group, it was collected from acute ischemic stroke starting young patients in jiaozuo coal group central hospital neurology department from August2006to August2011, and96cases of young persons for the youth group from the same age; the research about the common risk factors was made between young stroke group and young control group; then young stroke group was divided into two groups according to age:youth group Ⅰ (18-35years), youth group Ⅱ (36-45years), and collected125patients of the same period more than65years old patients with acute ischemic stroke starting for older group, and the risk factors, pathogeny types according to TOAST (Trial of Org10172in Acute Stroke Treatment), magnetic resonance imaging and cerebral vascular examination in different age stroke groups were compared and analyzed. All data were analyzed by SPSS12.0software. Results:1.Common risk factors of ischemic stroke in young adults:hypertension (OR=4.80,95%CI:2.28,10.07), hyperlipidemia (OR=3.94,95%CI:1.71,9.07), diabetes (OR=3.83,95%CI:1.27,11.61), heart disease (OR=5.79,95%CI:1.92,17.45), vasculitis (OR=6.56,95%CI:1.58,17.38), hyperhomocysteinemia (OR=3.25,95%CI:1.24,8.55) and smoking (OR=2.50.95%CI:1.13,5.53).2.Clinical features of different age stroke groups:(1)The top three risk factors were:youth group Ⅰ:hyperhomocysteinemia, hypertension, heart disease, smoking; youth group Ⅱ:hypertension, smoking, hyperlipidemia; older group:hypertension, hyperlipidemia and smoking.(2)Etiology types:in youth group Ⅰ ischemic stroke was caused mainly by undetermined etiology (UND) and other determined etiology (OTH)(45.1%and22.6%), while the cause of the youth group Ⅱ and older group was large artery atherosclerosis(LAA) mainly (40.0%and40.8%), there was no difference in the rate of cardio embolism(CE) among the groups.(3)Lesion distribution ratio in the system of internal carotid artery and vertebrobasilar of three groups patients, respectively:youth group Ⅰ22cases:9cases (71.0%:29.0%); youth group Ⅱ48cases:17cases(73.8%:26.2%); and older group94cases:31cases (75.2%:24.8%).(4)Cerebrovascular examination results:the rate of cerebral vascular stenosis three groups was high, as follows:youth group Ⅰ41.9%, youth group Ⅱ67.7%, older group85.6%; youth groups with single vessel disease, the older group with multivessel disease as common. Vascular stenosis was mainly distributed in the system of internal carotid artery, especially in the middle cerebral artery and internal carotid artery.Conclusion:1. The common risk factors of ischemic stroke in young adults were:hypertension, hyperlipidemia, diabetes, heart disease, vasculitis, hyperhomocysteinemia and smoking;2. The clinical features of ischemic stroke in young adults: (1)The major risk factors were different among the different age groups, ischemic stroke patients below35years of age:hyperhomocysteinemia, hypertension, heart disease and smoking,35-45years of age:hypertension, smoking, hyperlipidemia.(2)TOAST typing:ischemic stroke patients below35years of age to UND and OTH,35-45years of age with early-onset atherosclerosis is an important cause of young ischemic stroke.(3)The rate of vascular stenosis of young ischemic stroke was high, and single-vessel disease was common. |
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