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The Analysis of Etiology of Acute Cerebral Ischemic Stroke

Author: LuoShaoCheng
Tutor: LiuJunYan
School: Hebei Medical University
Course: Neurology
Keywords: Ischemic stroke TOAST Cause of disease Large artery atherosclerosis stroke Small artery stroke Unexplained ischemic stroke Cardiogenic cerebral embolism The other reasons initiator ischemic stroke
CLC: R743.3
Type: Master's thesis
Year: 2010
Downloads: 109
Quote: 0
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Abstract


Objective: Stroke is a common disease of the elderly, frequently-occurring disease has a high incidence, high morbidity, high mortality is the death of the elderly in China and the leading cause of adult disability, a serious threat to people's lives and health, a heavy burden to the society and the family. 80% of patients with stroke is ischemic stroke, ischemic stroke treatment program based on this specification, discover effective treatment for ischemic stroke to become the research focus of the medical profession enduring. The premise of the standard treatment need to clarify the etiology of stroke patients. This article to ischemic stroke TOAST (Trial of ORG l0172 in Acute Stroke Treatment) causes typing as a standard, the Third Affiliated Hospital of Hebei Medical University, Department of Neurology, the hospital received in the period from January 2002 to June 2007, the first acute ischemic stroke patients as research subjects to explore the characteristics of people with ischemic stroke etiology to help guide ischemic stroke prevention. . This typing method is mainly based on the clinical manifestations of stroke patients, comprehensive, detailed explanation of the cause of the stroke patients, become recognized as effective for acute ischemic stroke typing method, widely used in clinical studies . Method: the period from January 2002 to June 2007 in the Third Affiliated Hospital of Hebei Medical University, Department of Neurology, starting with acute ischemic stroke patients hospitalized for the study. ultrasound (TCD) and / or magnetic resonance angiography (MRA) and hematology testing etiology inspection. In addition, the composition of the population of all meet the inclusion criteria of the study the patient's age, gender, blood pressure, blood sugar, blood lipids, smoking history, drinking history, past history, family history and clinical data are required to be registered. TOAST typing methods: 1) large artery atherosclerosis stroke (large-artery Atherosclerosis LAA): This type of stroke patients were confirmed by TCD / MRA, carotid ultrasound scan clearly intracranial atherosclerotic stenosis or The Occlusion and responsibility vascular stenosis more than 50%. 2) small-artery stroke (the lacunar infarction small-Artery occlusion lacunars SAA) can be confirmed: with one of the following three criteria: (1) with a the typical lacunar infarction syndrome performance and imaging studies Visible in line with the clinical manifestations, the maximum diameter lt; 1.5 cm responsibility lesions; (2) with typical lacunar infarction syndrome performance, but imaging studies found no corresponding liability lesions; (3) with atypical lacunar infarction syndrome of performance, but imaging findings and clinical performance consistent, maximum diameter lt; 1.5 cm responsibility lesions. 3) cardiogenic cerebral embolism (cardioembolism CE): This category refers to a variety of cardiac sources of emboli disease caused by cerebral embolism. 4) other reasons caused by ischemic stroke (stroke of other Demonstrated Etiology SOE): This category is triggered by other causes of cerebral infarction, the clear cause of a hypercoagulable state, blood diseases, or taking drugs and so on. 5) unexplained ischemic stroke (stroke of other undemon-strated etiology, SUE): This category includes the above categories can not be attributed to ischemic stroke, with one of the following criteria can be attributed to this subtype; 1) After an extensive evaluation, can not find a clear reason caused by cerebral infarction; 2) cerebral infarction caused by two or more clear reason. Incomplete laboratory examinations are also included in this column. Intracranial and extracranial stenosis diagnostic criteria based on TCD and MRA [4-7] to determine the neck and intracranial vascular lesions, extent, location and collateral circulation state. SPSS17.0 software for statistical analysis, measurement data to mean ± standard deviation, count data to the number of positive cases, the constituent ratio of representation. The male and female patients with various subtypes constitute the line chi-square test to compare significant difference in level of 0.05. Results: A total of 1164 patients met inclusion criteria, 723 cases (62.1%) male patients, female patients, 441 cases (37.9%), mean age 62.5 ± 12.1 years of age (18 years to 89 years). 1164 cases of patients with ischemic stroke subtypes and gender composition: large artery atherosclerosis stroke (LAA) in 832 cases (71.48%), male 553 cases, female 279 cases; the small arteries stroke (SAA), 249 cases (21.39%), 116 cases, 133 women; cardiogenic cerebral embolism (CE) 36 (3.09%), 21 males and 15 females; other reasons lead to ischemic stroke (SOE) in 10 cases 37 cases (3.18%) (0.86%), males and 6 cases, 4 females; unexplained ischemic stroke (SUE), 27 males and 10 females. The results of this study by the chi-square test analysis, a statistical difference between the constituent ratio of female patients TOAST subtypes. Conclusion: the local domain ischemic stroke TOAST etiology and typing various types of proportion in order from largest to smallest: large artery atherosclerosis stroke (LAA); the small arteries stroke (SAA); unexplained ischemic stroke (Sue); cardiogenic cerebral embolism (CE); ischemic stroke caused by other reasons (SOE). 2, a statistical difference between the constituent ratio of female patients TOAST subtypes.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke)
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