Retrospective Analysis Of Clinical Data Of Patients With Acute Cerebral Infarction Based On TOAST Classification

Objective:The clinical data of patients with acute cerebral infarction were classified by TOAST and analyzed retrospectively to define the overall incidence of acute cerebral infarction in this center,as well as the pathogenesis,risk factors and treatment effects of different subtypes,thus summing up the viewpoint that has clinical application value,so as to provide scientific guidance for the screening,prevention,control and treatment of early risk factors of acute cerebral infarction.Methods:A retrospective study of 305 hospitalized patients with acute cerebral infarction diagnosed by neurology at the Sino Japanese Friendship Hospital of Jilin University from June 2015 to June 2016 was carried out.They were classified according to the TOAST etiology typing criteria.The data were collected and arranged.The general population,the general situation,risk factors and blood biochemical indicators of each subtype,as well as other results were statistically analyzed.Results:1?General condition:In all patients,the sex ratio of men and women was 1.6:1?188/117?,and males were the majority;The average age at first onset was62.8±11.4 years old.According to the age group,there were 103 patients?33.8%?in the age range of 60-69,and the number of first patients was the largest;There were288?94.4%?first married cases and 295 cases?96.7%?had Han nationality.2?Past and personal history of the patient:There were 270?88.5%?cases of hypertension and 51?16.7%?cases of diabetes in the past history.There were 137?44.9%?cases of annual smoking and 112?36.7%?cases of drinking.3?The patient's disease outcome,the hospitalization days and the hospitalization fee:The condition was improved in 291?95.4%?cases.The average hospitalization days was 11.62±4.368 days,and the average hospitalization expenses was 13838.49±6734.672 yuan.4?The constitution of patients based on TOAST typing:After TOAST typing,there were 29?9.5%?patients with CE,79?25.9%?patients with LAA,148?48.5%?patients with SAA,28?9.2%?patients with SOE,and 21?6.9%?patients with SUE,with the highest proportion of patients with SAA.5?The general condition based on TOAST typing:Based on TOAST typing,the differences of sex,age,nationality in the five subtypes were statistically analyzed.Gender differences were not statistically significant??2=0.626,p=0.960?.In ethnic factors,the difference between the groups was not statistically significant by the Fisher exact probability method?p=0.719?.Because of the small proportion of other ethnic diseases,the result of the test is not reliable.There was no statistically significant difference in age??²=7.941,P=0.439?.6?The past and personal history based on TOAST typing:The difference among the five subtypes in hypertension was statistically significant??²=52.782,P=0.000?.The subgroups of CE and SOE,CE and SUE,LAA and SOE,LAA and SUE,SAA and SOE,SAA and SUE had significant differences in hypertension;No statistically significant difference was found among the five subtypes in smoking??²=1.175,p>0.882?,as well as in drinking??²=5.630,p=0.229?.7?Biochemical indicators based on TOAST typing:The blood biochemical indicators of five subtypes were analyzed:There was no statistical difference in blood homocysteine(F_hcy=0.296,P_hcy=0.880)and the blood glucose test(F_GLU=0.568,P_GLU=0.686).There was no significant difference in blood TG(F_TG=2.035,P_TG=0.090).There was no significant difference in blood CHOL(F_CHOL=0.389,P_CHOL=0.817).The difference of blood LDLC was statistically significant(F_LDLC=2.854,P_LDLC=0.024).By pairwise comparison,the differences between CE and SOE,LAA and SOE,SAA and SOE were statistically significant.8?Other indicators based on TOAST typing:There was significant difference in the hospitalization days?F_d=1.576,P_d=0.181?and hospitalization fee?F_f=0.034,P_f=0.998?.The Fisher exact probability analysis showed no significant difference between the groups in terms of hospitalization outcome?P=0.412?.Conclusion:1.After TOAST typing,small artery stroke accounts for the most in this study,and there was no statistical difference in age,sex and nationality among the subgroups.2.In this study,after TOAST typing,the differences between CE and SOE,CE and SUE,LAA and SOE,LAA and SUE,SAA and SOE,SAA and SUE were statistically significant in hypertension.Hypertension based diseases may be the factors that cause the difference of morbidity of different subtypes.The prevention and treatment of hypertension is important for the prevention of subtypes of cerebral infarction.3.After TOAST typing,in terms of blood LDLC,after pairwise comparison,the differences between CE and SOE,LAA and SOE,SAA and SOE were statistically significant.