Studies Of Risk Factors And CISS Subtype Of Acute Ischemic Cerebral Stroke In210Young Audlts

Objective To analysis the difference of risk factors for acute ischemic cerebral strokebetween in young adults and in the middle-old aged these ten years. The ratio ofetiology subtype for young stroke patients based on Chinese ischemic strokesubclassification(CISS) was evaluated in this work. In addition, process of screeningetiologies of acute young ischemic stroke was first proposed.Methods Reviewed retrospectively210consecutive acute ischemic stroke patiens (18to44years old) and190middle-old inpatients from Beijing An Zhen Hospital of theCapital Medical University.190cases were admitted by randomized from software inour department of Neurology in Our hospital from January2002to December2011.The ratios of gender between young and middle-old group was close. The11riskfactors for stroke and distribution of CISS subtype were further studied by using thestatistical method, e.g. the chi-square test(2). According to resuts, charateristic ofischemic stroke for young adults was summarized. Process of screening for etiologyof acute ischemic stroke patients was developed.Results a. Baseline：in the young group (210cases), average age of38.9±5.4yearsold, male accounted for173cases(82.3%) and the control group (190cases), averageage of66.2±10.2years old, male accounted for154cases(81.1%). Both of thosegroups was not statistically significant(P>0.05). b. The most common risk factors ofyoung group were smoking at present(140cases,66.7%), intra-and extracranial largearteries stenosis(136cases,64.8%) and hyperlipidemia(116cases,55.2%). Comparedwith middle-aged and old group, the difference was statistically significant(P＜0.01).c. The main CISS subtypes in both groupes were intra-and extracranial large arteriesatherosclerosis(young group77cases,36.7%; middle-old group93cases,48.9%) andpenetrating artery disease(PAD)(young group70cases,33.3%; middle-old group57cases,30.0%), the two groups was not statistically significant (P>0.05).Hypoperfusion/impaired emboli clearance(31cases,40.3%) was common inthe young groupe(40.3%) in intra-and extracranial large arteries atherosclerosissubtype, howerver， parent artery (plaque or thrombus) occluding penetrating artery（42cases,45.2%）in the middle-old group. Hypertentsion, smoking at present,hyperlipidemia and heart diseases was statistically significant(P＜0.01) in two groupwhich were related to intra-and extracranial large arteries atherosclerosis. Intra-andextracranial arteries stenosis in young group（58cases,75.3%）and another group(18cases,19.4%), the differences was statistically significant(P＜0.01). Smoking atpresent49cases(70%) in young group and7cases(12.3%) in old group, difference intwo groups was statistically significant(P＜0.01). d. Stenosis of basal artery beweenttwo groups was not statistically significant (P>0.05). Stenosis of vertebral artery wasstatistically significant(P＜0.05). Stenosis of internal carotid artery, subclavian artery,anterior cerebral artery, middle cerebral artery and posterior cerebral artery werestatistically apprently significant(P＜0.01).g. Mode of screening etiologies in clinicalpathway of acute young ischemic stroke was first proposed.Conclusion a. Smoking at present, intra-and extracranial arteries stenosis andhyperlipidemia were main modified risk factors in young adults. b. The main CISSsubtypes in young groupe were intra-and extracranial large arteries atherosclerosiswhich in. Hypoperfusion/impaired emboli clearance was most common intra-andextracranial large arteries atherosclerosis subtype in young group. In this subtype,smoking at present and hyperlipidemia were vital risk factors and young adults werediagnosis for intra-and extracranial arteries stenosis. c. Mode of screening foretiology of acute ischemic stroke patients was developed，which was useful foretiology diagnosis and second prevention for young adults suffed ischemic stroke.