Abstract: Objective To investigate the etiology classification features and related risk factors of ischemic stroke in young adults. Methods We retrospectively analyzed the clinical data of 120 successive patients with first-ever ischemic stroke in young adults from January 2010 to June 2014 in the Department of Neurology, Beijing Haidian Hospital as young patient group. And 136 middle-aged and old patients with ischemic stroke were selected randomly as control group. The clinical data of all the subjects were collected. The study was to identify the etiology classification and related risk factors in whole cohort, and further to compare the difference between the two groups in above characteristics based on China Ischemic Stroke Subclassification (CISS). Results There were 82 (68.3%) male and 38 (31.7%) female in young ischemic stroke group. There were 76 (55.9%) male and 60 (44.1%) female in the control group. Male stroke incidence in the young group was significantly higher than in the elderly group ( χ 2 =4.183, P =0.041). The CISS classification in young patient group was as follows: large artery atherosclerotic (LAA)25.8%, stroke of other undetermined etiology (SUE) 22.5%, perforating branch artery occlusion (PAO) 20.8%, cardioembolism (CE) 19.2%, stroke of other etiology (SOE) 11.7%. Middle-aged and old patient group showed LAA 40.5%, PAO 33.8%, CE 21.3%, SOE 2.9%, SUE 1.5%. LAA, PAO, SOE, SUE between the two groups were significantly different except CE ( P <0.05). The youth group SOE, SUE etiology classification was obviously higher than in the control group, and the difference was significant ( P <0.05). Young ischemic stroke risk factors of the top 5 are smoking 48.3%, hypertension 44.2%, hyperlipidemia 40.8%, alcohol drinking 36.7%, family history of stroke 23.3%. In contrast, the middle-aged stroke group is hypertension 57.4%, diabetes 47.1%, hyperlipidemia 43.4%, carotid atherosclerosis 37.5%, smoking 35.3%. Comparison of risk factors between the two groups, young group, smoking, drinking and family history of stroke was significantly higher than that in the middle-aged and old group.There was significant difference between two groups ( P <0.05). Conclusion Young ischemic stroke etiology classification characteristics and related risk factors differ from the middle-aged and old patients. Early etiological classification and detection of risk factors are beneficial to the prevention and treatment for ischemic stroke in young adults.

Key words: Ischemic stroke; Young adults; Etiology classification; Risk factors

摘要： 目的 探讨青年缺血性卒中患者的病因分型构成特点和相关危险因素。 方法 回顾性分析北京市海淀医院神经内科2010年1月～2014年6月连续登记的120例青年首发缺血 性卒中患者， 同时选取同期住院的中老年缺血性卒中患者136例作为对照， 收集所有研究对象的临床 资料， 根据中国缺血性卒中亚型 （China Ischemic Stroke Subclassification， CISS） 明确所有研究对象的病 因分型及其危险因素， 比较两组患者的病因分型特点及相关危险因素特点。 结果 青年缺血性卒中组男性82例 （68.3%） ， 女性38例 （31.7%） ； 中老年组男性76例 （55.9%） ， 女 性60例 （44.1%） 。 两组性别相比差异具有显著性 （ χ 2 =4.183， P =0.041） 。 CISS分型青年组依次为大动 脉粥样硬化 （large artery atherosclerosis， LAA） 25.8%， 原因不明 （stroke of other undetermined etiology， SUE） 22.5%， 穿支动脉闭塞 （perforating branch artery occlusion， PAO） 20.8%， 心源性 （cardioembolism， CE） 19.2%， 其他病因 （stroke of other etiology， SOE） 11.7%。 中老年组依次为LAA 40.5%， PAO 33.8%， CE 21.3%， SOE 2.9%， SUE 1.5%。 青年缺血性卒中和中老年缺血性卒中两组间病因分型除CE差异无 显著性外， LAA、 PAO、 SOE、 SUE两组比较均差异具有显著性 （ P ＜0.05） 。 其中青年组SOE、 SUE病因分 型比例明显高于中老年组， 差异有显著性 （ P ＜0.05） 。 青年组排前5位的危险因素分别是吸烟48.3%， 高血压44.2%， 高脂血症40.8%， 饮酒36.7%， 卒中家族史23.3%。 而中老年组分别是高血压57.4%， 糖 尿病47.1%， 高脂血症43.4%， 颈动脉粥样硬化37.5%， 吸烟35.3%。 两组间相关危险因素比较， 青年 组吸烟、 饮酒、 卒中家族史明显高于中老年组， 两组比较差异有显著性 （ P ＜0.05） 。 结论 青年缺血性卒中病因分型构成特点和相关危险因素与中老年患者分布不同。 早期明确病因分 型和发现危险因素有利于青年缺血性卒中的防治。

关键词: 缺血性卒中; 青年; 病因分型; 危险因素