TOAST Classification And Risk Factors Analysis Of Ischemic Stroke In Youth

Objective:To investigate the etiology of ischemic stroke in young people and the possible risk factors for different TOAST subtypes.Methods:A retrospective analysis was performed on 169 patients with acute ischemic stroke who were admitted to the Department of Neurology,First Hospital of Handan City from October 2017 to January 2019.Head MRI and/or head CT,acute ischemic cerebral infarction is clearly diagnosed,all meet the diagnostic criteria of acute ischemic stroke.After admission,basic information,past medical history,personal history,family history and TIA episodes were collected.In the history,ECG examination and laboratory index examination were performed within 24 hours after admission.Some patients underwent cervical vascular ultrasound,DSA,24-hour dynamic electrocardiogram,echocardiography,and transesophageal echocardiography(TEE).According to the TOAST classification,the cases were divided into different subtypes,and the etiology of the young stroke patients and the relationship between different subtypes and possible risk factors were analyzed statistically.Results:(1)There were 169 young patients with ischemic stroke,including 99 male patients and 70 female patients.The proportion of males was significantly higher than that of females.The minimum age was 22 years old,and the average age was 39.9±4.7 years old.The average age of the patients was 39.8±4.9 years,the average age of female patients was 40.4±4.0 years old,and the ratio of male to female was 1.41:1.(2).From the study,the proportion of unexplained cerebral infarction was the highest,with a total of 61 people.The composition ratio was 36.1%,and the other 4 types were 41 atherosclerotic(LAA),the ratio was 24.3%,and the small arterial occlusion(SAA)was 40,with a composition ratio of 23.4%.20 patients with clear cause(OE),the composition ratio was 11.8%,7 patients with cardiogenic embolism(CE),the composition ratio was 4.1%.(3)The most common risk factor was 92 cases(54.4%)of hyperlipidemia,The risk factors of the disease ranged from high to low:82 cases(48.5%)with hypertension,79(46.7%)overweight,67cases(39.6%)with high homocysteinemia,and 56 cases with smoking history.(33.1%),37 cases(21.9%)in drinking history,20 cases(11.8%)in family history,20 cases(11.8%)in type 2 diabetes,TIA History of 17 cases(10.1%).(4)After statistical analysis,the occurrence of ischemic stroke in young people has a clear correlation with hypertension,diabetes,hyperlipidemia,smoking history and family history;LAA and SAA in males with ischemic stroke are very large.Proportion,but male incidence was higher than female in LAA(X2=0.65,P=0.002),male incidence was not statistically significant in SAA(X2=3.76,P=0.52);CE The incidence was higher in male patients,which was not statistically significant(X2=0.267,P=0.605).The incidence of females in SOE subtypes was higher(X2=12.845,P=0.00),SUE Asia.The incidence of women was higher in women,and the prevalence of men and women was statistically significant(X2=4.186,P=0.041).The occurrence of subtypes in TOAST classification was associated with different risk factors,and the occurrence of LAA was associated with overweight,which was statistically significant(X2=0.550,P=0.025).The occurrence of SAA was associated with hypertension and hyperlipidemia.Statistical significance,the occurrence of CE and hypertension,hyperlipidemia,statistically significant,the occurrence of OE is associated with hypertension,hyperlipidemia,smoking,statistically significant,the occurrence of UE and hypertension,type 2 Diabetes,hyperlipidemia smoking and family history were statistically significant.Conclusion :(1)Young patients with ischemic cerebral infarction have a high proportion of hyperlipidemia,hypertension,overweight,hyperlipidemia,smoking and drinking.(2)With the increase of age,the incidence of ischemic stroke in young people is obvious.Increased,and male incidence is higher than female.(3)Male patients are more prone to LAA,and female patients are more susceptible to OE and UE.(4)Hypertension,diabetes,hyperlipidemia,smoking,family history affect the type of cerebral infarction in young people,suggesting that we should be more targeted in clinical workcorresponding to different subtypes and risk factors,corresponding to individualized Treatment and preventive measures.