Abstract: Objective  To explore the influencing factors and prognosis of non-minor ischemic stroke in young adults, with the aim of reducing the rate of severe cases.
Methods  Young patients with ischemic stroke hospitalized in the Department of Neurology, the Second Affiliated Hospital of Naval Medical University from January 2016 to January 2022 were analyzed. According to the NIHSS score within 2 hours of the first visit, they were divided into the minor group (NIHSS score≤3 points) and the non-minor group (NIHSS score>3 points). The basic clinical characteristics, risk factors, TOAST classification, and 90-day outcomes of the two groups were recorded in detail, and the differences between the two groups were compared. Logistic regression analysis was used to explore the risk factors and prognostic factors of non-minor ischemic stroke in young adults.
Results  A total of 185 patients were included in the study, with an average age of (38.72±5.24) years and 137 males (74.05%). Among them, 92 cases were in the non-minor group and 93 cases in the minor group. The proportions of risk factors were relatively high for hypertension (47.03%), smoking (41.08%), diabetes mellitus (20.54%), and hyperlipidemia (20.00%). There were statistically significant differences in the presence or absence of diabetes mellitus, heart disease, and TOAST classification between the two groups (P<0.05). Multivariate logistic regression analysis showed that diabetes mellitus (OR 2.483, 95%CI 1.076-5.726, P=0.033) and heart disease (OR 7.948, 95%CI 1.691-37.367, P=0.009) were independent risk factors for non-minor ischemic stroke in young adults. Regression analysis showed that the neurological function and anxiety levels at 90 days were positively correlated with the severity of neurological function at the onset of the disease (P<0.05).
Conclusions  Young people with diabetes mellitus and heart disease have a high risk of severe disease after stroke, and the prognosis is relatively poor at 90 days. Early identification and active intervention should be carried out to reduce the incidence of the disease and decrease the rate of severe cases.

Key words: Young adult; Ischemic stroke; Non-minor ischemic stroke; Minor ischemic stroke; Influencing factor

摘要： 目的 探讨青年非轻型缺血性卒中的影响因素及预后，以期降低重症率。
方法 分析2016年1月—2022年1月于海军军医大学第二附属医院神经内科住院的青年缺血性卒中患者，依据首诊2 h内NIHSS评分分为轻型组（NIHSS评分≤3分）与非轻型组（NIHSS评分>3分），详细记录两组临床基本特征、危险因素、TOAST分型及90 d结局，比较两组差异。采用logistic回归分析探讨青年非轻型缺血性卒中的危险因素和预后影响因素。
结果 共185例患者纳入研究，平均年龄为（38.72±5.24）岁，男性137例（74.05%）；非轻型组92例，轻型组93例。危险因素中比例较高的是高血压（47.03%）、吸烟（41.08%）、糖尿病（20.54%）、高脂血症（20.00%）。两组在有无糖尿病、心脏病、TOAST分型方面差异有统计学意义（P<0.05）。多因素logistic回归分析显示，糖尿病（OR 2.483，95%CI 1.076～5.726，P=0.033）与心脏病（OR 7.948，95%CI 1.691～37.367，P=0.009）是青年非轻型缺血性卒中的独立危险因素。回归分析显示90 d神经功能及焦虑情绪与发病时神经功能严重程度呈正相关（P<0.05）。
结论 青年罹患糖尿病、心脏病者卒中后重症风险大，90 d预后相对较差，应早期识别、积极干预，减少发病的同时降低重症率。

关键词: 青年; 缺血性卒中; 非轻型缺血性卒中; 轻型缺血性卒中; 影响因素