| Background:Young people ischemic stroke refers to the ischemic stroke in people of 18-45 years old.The incidence rate of ischemic stroke in young people is increasing nowadays,which will have a serious impact on themselves,their families and even society.At present,there are more and more research on the risk factors of ischemic stroke in young people.We can prevent the occurrence of the disease more effectively by defining the risk factors.According to the subtypes of ischemic stroke in China,we can divide the etiology of ischemic stroke more carefully,and give targeted treatment.Moreover,the risk factors closely related to different subtypes are different.It can also give targeted prevention to clarify the risk factors of different subtypes with different emphasis.The prognosis of young ischemic stroke is also a focus of current research,to understand the risk factors related to prognosis,and to reduce the outcome of poor prognosis.Objective:Statistical analysis of the common risk factors of young patients with acute ischemic stroke admitted in the last two years;according to the Chinese ischemical stroke subcategorization(CISS),analysis of the proportion of etiology classification of young stroke patients and the difference of different risk factors in each etiology classification;analysis of the impact of different risk factors on the prognosis of young patients with ischemic stroke.Method:From September 2017 to September 2019,96 young patients with ischemic stroke who were admitted in the Department of Neurology,Huaihe hospital,Henan University were selected as the case group,and 82 young people who were expected to have a normal physical examination in the physical examination center of our hospital were selected as the control group.The data of 96 young patients with ischemic stroke were collected,including sex,smoking history,drinking history,hypertension history,diabetes history,coronary heart disease history,atrial fibrillation history,also recorded their laboratory finding include total bilirubin,direct bilirubin,indirect bilirubin,total cholesterol,triglyceride,blood uric acid,C-reactive protein,ESR,homocysteine,plaque in the neck,and NIHSS evaluation on admission.The differences between the young ischemic stroke group and the healthy control group were statistically analyzed.According to the classification method of CISS in China,the patients were divided into large-scale atherosclerosis(LAA),cardiogenic stroke(CS),perforating artery disease(PAD),other etiologies(OE)and Unknown etiology(UE).Analyze the differences between the above factors in different subtypes of young ischemic stroke.According to the m RS score,the patients were divided into two groups,with a score of 0-2(excluding 2 points)for the group with good prognosis,and 2-6(including 2 points)for the group with poor prognosis.The recovery of the patients after one month and three months were followed by telephone,and follow-up result was analyzed to evaluate the relationship between the above factors and the prognosis of the patients.Result:1.According to the exclusion and inclusion criteria,96 young patients with ischemic stroke were collected in this study,including 82 males(85.4%)and 14 females(14.6%);82 healthy people of control group,including 41 males(50.0%)and 41 females(50.0%).The factors that may cause ischemic stroke in young people: gender,history of atrial fibrillation,history of diabetes,history of hypertension,history of coronary heart disease,history of smoking,history of drinking,total bilirubin,direct bilirubin,indirect bilirubin,total cholesterol,triglyceride,cervical plaque,UA,CRP,ESR,and Hcy were compared and analyzed.The results showed that male,smoking history,drinking history,diabetes,hypertension,total cholesterol,UA,Hcy,CRP,ESR,and cervical plaque were higher than those in the control group(P < 0.05),total bilirubin and direct bilirubin were lower than those in the control group(P < 0.05),but coronary heart disease,atrial fibrillation,indirect bilirubin,and triglyceride had no difference between the two groups.The above risk factors(P < 0.05)were included in the multiple factor Logistic regression analysis.The youth ischemic stroke was taken as the dependent variable,and the multiple factors were compared with smoking history,drinking history,diabetes,hypertension,total cholesterol,total bilirubin,direct bilirubin,UA,Hcy,CRP,ESR,and cervical plaque.Logistic regression analysis showed that male,total cholesterol,total bilirubin,direct bilirubin,UA,CRP,and Hcy were the risk factors of cerebral infarction in young people(P < 0.05).2.According to CISS classification,96 young patients with cerebral infarction were divided into three types: LAA type 46(47.9%),PAD type 31(32.3%),CS type 7(7.2%),OE type 6(6.3%),UE type 6(6.3%).There was significant difference in smoking history,Hcy,(P < 0.05),no significant difference in sex,drinking,coronary heart disease,atrial fibrillation,hypertension,diabetes,total cholesterol,triglyceride,direct bilirubin,indirect bilirubin,total bilirubin,neck plaque,NIHSS score,ESR,UA,CRP.The results showed that the proportion of smoking history and Hcy in the risk factors of all CISS subtype,LAA was the highest(P < 0.05).3.Single factor analysis of sex,smoking history,drinking history,atrial fibrillation,hypertension,diabetes,coronary heart disease,total bilirubin,direct bilirubin,indirect bilirubin,total cholesterol,triglyceride,NIHSS score,cervical plaque,ESR,CRP,UA,Hcy showed that total bilirubin,NIHSS score,uric acid,CRP,Hcy might be the risk factors of poor prognosis in one month.Through logistic regression analysis,it was found that uric acid,Hcy,and NIHSS scores were correlated with the prognosis,which were independent risk factors for poor prognosis of young cerebral infarction in one month.4.Single factor analysis of sex,smoking history,drinking history,atrial fibrillation,hypertension,diabetes,coronary heart disease,total bilirubin,direct bilirubin,indirect bilirubin,total cholesterol,triglyceride,NIHSS score,cervical plaque,ESR,CRP,UA,Hcy showed that total bilirubin,NIHSS score,CRP,Hcy might be the risk factors of poor prognosis in three months One step through multivariate logistic regression analysis,we found that CRP,Hcy and NIHSS scores were correlated with the prognosis,which were independent risk factors for poor prognosis of young cerebral infarction in 3 months.Conclusions:1.Male,total cholesterol,high CRP,high UA,high Hcy,low direct bilirubin,low total bilirubin are independent risk factors of young people with ischemic stroke;2.Among the different subtypes of CISS in young people ischemic stroke,LAA subtype is the most common one,followed by PAD subtype;there are statistical differences in smoking history and Hcy among the different subtypes;3.High NIHSS score,high UA,high Hcy and high CRP were the independent risk factors of poor prognosis in young people ischemic stroke. |
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