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目的探讨青年女性脑梗死患者常见的危险因素及其对发病年龄的影响。方法回顾性分析2000年11月1日—2010年10月31日,在首都医科大学宣武医院住院的260例青年女性新发脑梗死患者的临床资料,观察青年女性脑梗死的常见危险因素,采用Logrank时序检验分析各危险因素对发病年龄的影响。结果①260例患者中,36～45岁患者最多(65.8%),18～25岁患者最少(11.5%)。最常见的危险因素是高血压(39.2%)、糖尿病(14.6%)、高脂血症(8.1%);其次是卵圆孔未闭(4.2%)、烟雾病(3.8%)、高同型半胱氨酸血症(3.5%)、血管炎(3.5%)及心房颤动(3.5%)等;高血压的发生率随着年龄的增长而上升(χ2=17.573,P<0.01),卵圆孔未闭的发生率随着年龄增长而降低(χ2=12.666,P<0.01)。②TOAST分型:原因不明性型占31.2%(81/260);大动脉粥样硬化型占26.9%(70/260);小动脉闭塞型和其他病因明确型,分别占16.5%(43/260)、15.0%(39/260);心源性栓塞型占10.4%(27/260)。③Logrank时序检验分析,并未发现有高血压、糖尿病、高脂血症及心房颤动患者的卒中发病年龄低于平均年龄;而患有房间隔缺损、卵圆孔未闭、血管炎的患者,发生脑梗死时的年龄[中位数年龄(95%CI)],分别为26(13～39)、29(19～39)、35(33～37)岁,低于该组的平均年龄[39(38～40)岁],均P<0.05。结论青年女性脑梗死患者最常见的危险因素是高血压病、糖尿病、高脂血症,烟雾病、卵圆孔未闭,同型半胱氨酸血症及血管炎亦占有较高的比例;其中患有房间隔缺损、卵圆孔未闭、血管炎者,发生脑梗死的年龄较小。
Objective To explore the common risk factors of young female patients with cerebral infarction and their impact on the age of onset. Methods The clinical data of 260 young women with new-onset cerebral infarction hospitalized at Xuanwu Hospital, Capital Medical University from November 1, 2000 to October 31, 2010 were retrospectively analyzed. The common risk factors of cerebral infarction in young women were observed. Logrank time series analysis of the impact of risk factors on the age of onset. Results (1) Among the 260 patients, the highest was 36-45 (65.8%) and the other was 18- 25 (11.5%). The most common risk factors were hypertension (39.2%), diabetes (14.6%) and hyperlipidemia (8.1%), followed by patent foramen ovale (4.2%), moyamoya disease (3.8%), hyperhomocysteinemia Cystinemia (3.5%), vasculitis (3.5%) and atrial fibrillation (3.5%). The incidence of hypertension increased with age (χ2 = 17.573, P <0.01) The incidence of patent loss decreased with age (χ2 = 12.666, P <0.01). ②TTOAST classification: the cause of unknown type accounted for 31.2% (81/260); atherosclerosis accounted for 26.9% (70/260); arteriole occlusion and other etiological types, accounting for 16.5% (43/260) , 15.0% (39/260); cardiogenic embolism accounted for 10.4% (27/260). ③Logrank time series analysis did not find that the age of onset of stroke in patients with hypertension, diabetes, hyperlipidemia and atrial fibrillation was lower than the mean age; patients with atrial septal defect, patent foramen ovale and vasculitis did not occur The median age (95% CI) at cerebral infarction was 26 (13 to 39), 29 (19 to 39) and 35 (33 to 37) years, respectively, lower than the mean age of the group [39 (38 ~ 40) years old, all P <0.05. Conclusions The most common risk factors for young women with cerebral infarction are hypertension, diabetes, hyperlipidemia, moyamoya disease, patent foramen ovale, homocysteine and vasculitis. Among them, Suffering from atrial septal defect, patent foramen ovale, vasculitis, cerebral infarction is younger.