Zhongguo cuzhong zazhi (Jun 2023)
青年与中老年椎动脉夹层伴缺血性卒中患者的危险因素、临床特征及影像表现比较 Comparison of the Risk Factors, Clinical Manifestations and Imaging Characteristics of Patients with Ischemic Stroke caused by Vertebral Artery Dissection in Young and Middle-senile Group
Abstract
目的 比较青年与中老年椎动脉夹层伴缺血性卒中患者的危险因素、临床特征及影像学表现。 方法 本研究为横断面研究，回顾性分析2018年10月—2023年1月在首都医科大学附属北京天坛医院住院，诊断为急性缺血性卒中且病因诊断为椎动脉夹层的患者。将患者分为青年组（＜45岁）和中老年组（≥45岁），比较两组危险因素、临床特征及影像学表现的差异。 结果 共纳入74例符合入组标准的患者，青年组45例，中老年组29例。青年组有头晕/眩晕症状的患者比例高于老年组（97.8% vs. 79.3%，P=0.008）。青年组伴有高血压、糖尿病、高脂血症、缺血性心脑血管病病史、动脉粥样硬化的比例低于中老年组。青年组发生颅内椎动脉夹层的比例低于中老年组（26.7% vs. 69.0%），颅外椎动脉夹层的比例高于中老年组（73.3% vs. 31.0%）。 结论 在椎动脉夹层所致缺血性卒中人群中，与中老年患者相比，青年患者伴有血管危险因素的比例低，颅内椎动脉夹层的发生率低，颅外椎动脉夹层的发生率高。 Abstract: Objective To investigate the risk factors, clinical manifestations and imaging characteristics of patients with ischemic stroke caused by vertebral artery dissection between young and middle-senile group. Methods This is a retrospective case-control study, we retrospectively included patients with ischemic stroke caused by vertebral artery dissection in Beijing Tiantan Hospital, Capital Medical University from October 2018 to January 2023. The patients were divided into young group (age<45) and middle-senile group (age≥45). Risk factors, clinical manifestations, and imaging characteristics were compared between two groups. Results A total of 74 patients were included, with 45 patients in the young group and 29 patients in the middle-senile group. The proportion of the patients with dizziness or vertigo in the young group is higher than that of the middle-senile group (97.8% vs. 79.3%, P=0.008). Incidence of hypertension, diabetes, hyperlipidemia, ischemic cardiovascular and cerebrovascular diseases history, and atherosclerosis in the young group were lower than that in the middle-senile group. The young group had lower proportion of intracranial vertebral artery dissection than that of the middle-senile group (26.7% vs. 69.0%, P<0.001), and higher proportion of extracranial vertebral artery dissection than that of the middle-senile group (73.3% vs. 31.0%, P<0.001). Conclusions Among the patients with ischemic stroke caused by vertebral artery dissection, compared with the middle-senile patients, the young patients had lower proportion of vascular risk factors, lower incidence of intracranial vertebral artery dissection, and higher incidence of extracranial vertebral artery dissection.
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