CAJ | 학술논문

目的探讨不同年龄段大动脉粥样硬化性脑梗死高危因素的差别,以利于采取不同的预防方式,减少脑梗死的发生率及复发率.方法回顾性分析192例大动脉粥样硬化性脑梗死患者的病历资料,按年龄分为青年组(46例)、中年组(57例)及老年组(89例).研究变量包括性别、既往病史(高血压、糖尿病)、长期吸烟、长期饮酒以及实验室检测指标(三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、同型半胱氨酸).结果青年组三酰甘油升高率及长期吸烟率显著高于老年组[60.9％(28/46)比22.5％( 20/89)、65.2％( 30/46)比29.2％( 26/89),P＜0.05].中年组男性比例及长期吸烟、长期饮酒率显著高于老年组[ 80.7％ (46/57)比59.6％ (53/89)、57.9％(33/57)比29.2％(26/89)、47.4％(27/57)比15.7％(14/89),P＜0.05].中年组高血压、糖尿病及长期饮酒率显著高于青年组[ 84.2％ (48/57)比60.9％ (28/46)、54.4％ (31/57)比26.1％(12/46)、47.4％( 27/57)比23.9％(11/46),P＜ 0.05].青年组三酰甘油升高率高于中年组[60.9％(28/46)比29.8％(17/57),P＜0.05].老年组高血压率显著高于青年组[83.1％(74/89)比60.9％(28/46),P＜ 0.05].各组在低密度脂蛋白胆固醇升高、同型半胱氨酸升高及高密度脂蛋白胆固醇降低方面比较差异无统计学意义(P＞ 0.05).结论不同年龄段大动脉粥样硬化性脑梗死预防侧重点不同,青年患者强调生活方式的改变,中年患者在生活方式改变基础上更强调血压、血糖的控制,老年患者则主要对血压进行控制.
목적 탐토불동년령단대동맥죽양경화성뇌경사고위인소적차별,이리우채취불동적예방방식,감소뇌경사적발생솔급복발솔.방법 회고성분석192례대동맥죽양경화성뇌경사환자적병력자료,안년령분위청년조(46례)、중년조(57례)급노년조(89례).연구변량포괄성별、기왕병사(고혈압、당뇨병)、장기흡연、장기음주이급실험실검측지표(삼선감유、저밀도지단백담고순、고밀도지단백담고순、동형반광안산).결과 청년조삼선감유승고솔급장기흡연솔현저고우노년조[60.9％(28/46)비22.5％( 20/89)、65.2％( 30/46)비29.2％( 26/89),P＜0.05].중년조남성비례급장기흡연、장기음주솔현저고우노년조[ 80.7％ (46/57)비59.6％ (53/89)、57.9％(33/57)비29.2％(26/89)、47.4％(27/57)비15.7％(14/89),P＜0.05].중년조고혈압、당뇨병급장기음주솔현저고우청년조[ 84.2％ (48/57)비60.9％ (28/46)、54.4％ (31/57)비26.1％(12/46)、47.4％( 27/57)비23.9％(11/46),P＜ 0.05].청년조삼선감유승고솔고우중년조[60.9％(28/46)비29.8％(17/57),P＜0.05].노년조고혈압솔현저고우청년조[83.1％(74/89)비60.9％(28/46),P＜ 0.05].각조재저밀도지단백담고순승고、동형반광안산승고급고밀도지단백담고순강저방면비교차이무통계학의의(P＞ 0.05).결론 불동년령단대동맥죽양경화성뇌경사예방측중점불동,청년환자강조생활방식적개변,중년환자재생활방식개변기출상경강조혈압、혈당적공제,노년환자칙주요대혈압진행공제.
Objective To explore different risk factors in different age groups patients with large-artery atherosclerotic cerebral infarction,in order to reduce the rates of cerebral infarction and relapse by taking different means of prevention.Methods One hundred and ninety-two patients with large-artery atherosclerotic cerebral infarction were divided into three groups by age:youth group (46 cases),middle age group (57 cases) and elderly group (89 cases).The study variables included sex,previous medical history (hypertension and diabetes),long-term smoking,long-term alcohol intake and laboratory parameters (triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,homocysteine).Results The rates of high triglyceride and long-term smokingin youth group were significantly higher than those in elderly group [ 60.9％ (28/46) vs.22.5％ (20/89),65.2％ (30/46) vs.29.2％ (26/89),P ＜ 0.05 ].The rates of male,long-term smoking and long-term alcohol intake in middle age group were significantly higher than those in elderly group [ 80.7％ (46/57) vs.59.6％ (53/89),57.9％ (33/57) vs.29.2％ (26/89),47.4％ (27/57) vs.15.7％ (14/89),P ＜ 0.05 ].The rates of hypertension,diabetes and long-term alcohol intake in middle age group were significantly higher than those in youth group [ 84.2％ (48/57) vs.60.9％ (28/46),54.4％ (31/57 ) vs.26.1％ ( 12/46 ),47.4％ (27/57) vs.23.9％ ( 11/46 ),P ＜ 0.05 ].The rate of high triglyceride in youth group was significantly higher than that in middle age group [60.9％(28/46) vs.29.8％(17/57),P ＜ 0.05 ].The rate of hypertension in elderly group was significantly higher than that in youth group [ 83.1％(74/89) vs.60.9％ (28/46),P ＜0.05].There was no significant difference in low-density lipoprotein cholesterol,homocysteine and high-density lipoprotein cholesterol in the three groups (P ＞0.05).Conclusions Key point is different for the prevention of large-artery atherosclerosis cerebral infarction of different age paragraph.The youth patient emphasizes the change of lifestyle.Middle age patient has more emphasis on blood pressure,blood glucose control of the risk factors based on the lifestyle change.The key of elderly patient is the control of blood pressure.