| Objective: In recent years,the incidence of stroke is younger.The risk factor spectrum of youth stroke is slightly different from that of elderly patients.Except for the traditional risk factors,some rare risk factors are very important for the onset of youth stroke.Therefore,it is important to explore and explore the cause of stroke in young people and to conduct targeted preventive interventions to reduce the incidence rate of stroke.Through collecting and sorting the disease data of young patients with stroke,this paper discusses the etiology and TCM syndrome classification characteristics,so as to provide help for clinicians to judge the etiology of patients,understand the etiological characteristics,and further guide the prevention and treatment of young patients.Methods: The clinical data of 464 young stroke patients from 2 Grade-A hospitals in Changchun were analyzed by cross-sectional investigation.The patients were confirmed by brain CT / MRI,and the NIHSS score at admission was evaluated.Physical and chemical examinations such as blood routine,blood glucose,blood lipid routine,blood uric acid,carotid artery color Doppler ultrasound and transcranial Doppler ultrasound were performed.Some patients underwent MRA and/or DSA.According to the type of onset,464 patients were divided into ischemic stroke group(394 cases)and hemorrhagic stroke group(70cases).The sex ratio,etiology,NIHSS level at admission and TCM syndrome distribution characteristics of the two groups were analyzed.According to toast classification standard,the etiological subtypes of ischemic stroke group were analyzed.SPSS 22.0 software was used for statistical analysis of the data,the proportion of each etiology and the proportion of each subtype in the ischemic group were counted,and chi square analysis and independent sample t test were used to explore the relationship between the variables.Results:1.Basic data: A total of 464 patients(356 males,108 females,male to female ratio of3.296)were collected.There were 394 patients in ischemic group(303 males,91 females,male to female ratio was 3.330,mean age 45.05±3.77),and 70 patients in hemorrhagic group(53 males,17 females,male to female ratio was 3.118,mean age 45.59±3.19).2.Risk factors: In the total sample,hypertriglyceridemia(78.8%),abnormal increase of BMI(68.9%),hypertension(62.8%)were the top three factors affecting youth stroke.In ischemia group,hypertriglyceridemia(74.6%),abnormal increase of BMI(68.5%)and hypertension(59.4%)were the top three factors;in hemorrhage group,the top three factors were hypertriglyceridemia(100.0%),hypertension(80.0%)and abnormal increase of BMI(71.4%).There were significant differences in hypertriglyceridemia,hypercholesterolemia,mixed dyslipidemia,increased low density lipoprotein cholesterol,hypertension and smoking between the two groups(p < 0.05).3.NIHSS level: The average NIHSS score of ischemia group was 3.43± 3.33,the average NIHSS score of hemorrhage group was 6.26 ± 5.19,the NIHSS score of hemorrhage group was significantly higher than that of ischemia group(p<0.05).4.TOAST classification: There were 253 cases(64.2%)of LAA,and the top three influencing factors were 226 cases(89.3%)of carotid atherosclerosis,195 cases(77.1%)of hypertriglyceridemia,183 cases(72.3%)of abnormal increase of BMI;There were 92 cases(23.3%)of SAO.The first three influencing factors were hypertriglyceridemia in 65 cases(72.2%),abnormal increase of BMI in 58 cases(63.0%),hypertension in 55 cases(61.1%).CE in 15 cases(3.8%),and carotid atherosclerosis in 12 cases(80.0%),heart disease in 11cases(73.3%),abnormal increase of BMI in 8 cases(53.3%).There were 5 cases(1.3%)of SOE.The first two influencing factors were hypertriglyceridemia in 5 cases(100.0%),hyperhomocysteinemia in 4 cases(80.0%),and stroke of undetermined cause(100.0%)Twenty nine patients(7.4%)were diagnosed as SUE.The first two influencing factors were hypertriglyceridemia in 21 patients(72.4%)and abnormal increase of BMI in 18 patients(62.1%).Toast subtypes were significantly associated with hypertension,low high density lipoprotein cholesterol,heart disease and carotid atherosclerosis(p< 0.05).5.TCM syndrome typing: In this study,a total of 165 patients were classified,including 139 cases in ischemia group and 26 cases in hemorrhage group.72 cases(52.8%)in ischemia group were wind phlegm obstructing collaterals,and 12 cases(46.2%)in hemorrhage group were hyperactivity of liver Yang and disturbance of wind fire.Dyslipidemia and drinking were significantly different in TCM syndrome types of ischemia group(p< 0.05),and hyperhomocysteinemia was significantly different in TCM syndrome types of hemorrhage group(p< 0.05).Conclusion:1.The incidence rate of male is higher than that of female,and men should pay more attention to prevention of stroke.2.The role of lipid metabolism diseases in youth stroke is becoming increasingly prominent.Youth should develop personalized lipid regulation program for targeted prevention.3.The overall neurological impairment of young stroke patients is mainly mild to moderate,but bleeding patients are faced with a higher risk of neurological impairment.4.In this study,LAA type is the most common,followed by SAO type.Risk factors related to early-onset atherosclerosis are still the key to prevention in young people.5.Wind,fire and phlegm are the key factors of youth stroke.Young people should make full use of the characteristic means of traditional Chinese medicine to strengthen the prevention and control of risk factors when they are not ill. |
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