Aetiological Diagnosis And Risk Factors Of Ischemic Stroke In Young Adults

Objective:To explore the causes and risk factors of ischemic stroke in youngadults, compared the distribution in different genders and different age groups(18to35,36to45), it is not only improve the level of youth cerebral infarction etiology diagnosisand guide the prevention and control measures of correct selection but also provide theclinical diagnosis and treatment strategy.Methods:We investigated165cases of young patients with cerebral infarction offirst episode(mean age38.2±5.8years), who admitted to our hospital from December2011to June2013by the retrospective analysis. All enrolled patients were classified inthe light of TOAST：Large artery atherosclerosis (LAA), small vascular (SAO),cardiogenic embolism(CE), other determined (OD) and undetermined etiology(UND),and CE was divided into high-risk patients and low-risk patients，OD was fall into arterydissection and other diseases; Invited those risk factors as the research targets, whichcontained hypertension, hyperlipidemia, diabetes, smoking, drinking, homo-cysteinehematic disease, the family history of stroke, the applications of illicit medicinal, fetation,puerperium，etc, all patients were grouped(different age groups-18-35,36-45; gendergroups). Use SPSS17.0to analyze experimental dates. Whether the above-mentionedtargets were compared with a significant differences in different genders and differentage stages of youth, and analyze the characteristics of distribution of the etiology ofcerebral infarction in different genders and age stages.Results:In this research were67females and98males, average ages is38.2±5.8．UND is the most common isoforms(35.76％). Cerebral infarction in young femalepatients with other determined etiology (OD) is more common,the large arteryatherosclerotic ischemic stroke and Small-artery occlusion ischemic stroke were more common in men. Youth cerebral infarction in different ages, its etiology is different, thelarge artery atherosclerotic and Small-artery occlusion ischemic stroke are more commonin35~45years group(X2=10.937，P=0.001；X2=9.110，P=0.003), other demonstratedetiology and un-demonstrated etiology are most common in18~35yearsgroup(X2=12.175，P=0.001； X2=5.85，P=0.016),Moya-moya disease and CAD is themost frequent cause for OD(20.3%).All the youth cerebral infarction in patients withdyslipidemia is the most common risk factors(49.1％，81/165)，followed by hypertension(47.9%,79/165), high homocysteinemia levels (39.4%,65/165) and smoking (33.3%,55/165).Different ages have different risk factors, hypertension(X2=42.553, P=0.000),blood lipid abnormality(X2=20.239，P=0.000) and high homocysteinemia are mostcommon in35~45years group.Different gender in hypertension, dyslipidemia, highhomocysteinemia levels have not statistical significance, tobacco(P=0.000) andalcohol(P=0.000) should be high attention in males. TOAST classification betweengroups of single factor analysis of risk factors: hypertension(X2=62.003, P=0.000)significantly increased in small artery occlusion type, dyslipidemia(X2=21.509，P=0.000)and smoking(X2=37.839，P=0.000) in aortic atherosclerotic model (LAA) increasedsignificantly. Diabetes don’t have statistical difference in each model.Conclusion:1.Information prompted that most ischemic stroke in youth is male patients, moreobvious increase after age35years, in this age group should be paid attention to the riskfactor intervention and lifestyle changes.2. The ischemic stroke in TOAST of unknown origin is the most common types;followed by LAA and SAO, but other causes also should be taken seriously; LAA andSAO is more common in male patients and older; female patients with other determinedetiology common. Under the age of35to other determined etiology and unknown origin.3.Risk factors for hypertension, alcoholism, diabetes, dyslipidemia, highhomocysteinemia and smoking common, and the incidence in the population over the age of35are more than35years of age. Young male patients with risk factors for ischemicstroke also focused on addicted to alcohol and tobacco; taking contraceptives, pregnancyor postpartum is the risk factors can’t be ignored for female patients. But young ischemicstroke have more diversity risk factors and special risk factors, for patients in the clinicalwork detailed laboratory and imaging examination may find potential causes, so as tocarry out more valid interventions.