The Analysis Of Risk Factors For Ischemic Stroke Based On OCSP Criteria

PARTⅠObjective To verify the accuration of the OCSP classification method in the diagnosis of acute ischemic stroke.Methods Using the prospective cohort study method,we consecutively registed acute ischemic stroke inpatients in our departments from 1 November 2008 to 31 March 2009.Patients were diagnosed both by OCSP classification method and CT or MRI imaging results,then the accuration of the OCSP classification method was evaluated by comparing with image results.Results Among 258 inpatients,the OCSP classification of 226 was consistent with the last image results.The total diagnostic consistency was 88%(226/258).The diagnostic consistency of every subtype was 90%for TACI(19/21),87%(71/82) for PACI,90%(119/133) for LACI,77% (17/22) for POCI.Conclusions The OCSP classification method based on clinical manifestation,having good consistency with imaging results,is a convenient and accurate classification method for acute ischemic stroke.PARTⅡObjective To investigate whether there was any difference between the distribution of risk factors among Oxfordshire Community Stroke Project(OCSP) subtypes in acute ischemic stroke inpatients.Methods We consecutively registed acute ischemic stroke inpatients in our departments from 1 November 2008 to 31 March 2009,using the prospective cohort study method.The patients were classified as total anterior circulation infarct(TACI),partial anterior circulation infarct (PACI),posterior circulation infarct(POCI) and lacunar infarct(LACI).The risk factors for ischemic stroke in all patients were assessed.Results There was no significant difference in smoking,alcohol consumption,history of transient ischemic attack,hypercholesterolemia,hyperhomocysteinemia,hyperfibrinogenemia among the four OCSP subtypes(P＞0.05).Compared with LACI and PACI,the incidence of atrial fibrillation in patients for TACI subtype was higher(P＜0.01).Besides there was significant difference in atrial fibrillation between POCI and TACI subtypes(P＜0.05).In LACI subtype,diabetes mellitus and hypertension were more frequent than in three other groups(P＜ 0.05).The incidence of carotidartery stenosis was not significantly different among the four OCSP subtypes(P＞0.05).But the incidence of serious carotidartery stenosis(stenosis≥50%) in anterior circulation infarct and posterior circulation infarct groups were higher than that in lacunar infarct group.There was no significant difference in incidence of patients with hypertension and diabetes mellitus,that of patient s with hypertension and atrial fibrillation and that of patients with diabetes mellitus and atrial fibrillation among the four OCSP subtypes(P＞0.05).Conclusions Atrial fibrillation is closely associated with total anterior circulation infarct. Diabetes mellitus and hypertension are popular in LACI.Carotidartery stenosis disproportionately causes ischemic stroke,but serious stenosis not mostly appears in LACI.