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基于TOAST和ASCO分型的轻型卒中病因学分型研究

  • 摘要: 目的研究轻型卒中与非轻型卒中病因学分型的差异,指导轻型卒中早期针对病因学的干预措施。方法回顾性纳入2012年7月至2014年7月于四川大学华西医院神经内科住院治疗的急性缺血性卒中患者,采用TOAST分型标准和ASCO分型标准对轻型卒中患者及非轻型卒中患者进行病因分型,对比两者在病因学分布上的差异。结果共纳入轻型卒中患者406例,非轻型卒中患者651例。两组TOAST分型构成比不同(P<0.001),其中轻型卒中组小动脉闭塞(SAO)比率最高,为40.4%(164例),非轻型卒中组原因未明型(SUE)比率最高,为30.9%(201例);轻型卒中组A1+2及C1+2占比均低于非轻型卒中组(22.8% vs. 35.4%, P<0.001;19.3% vs. 32.1%, P<0.001),S1+2占比高于非轻型卒中组(49.8% vs. 27.3%, P<0.001)。结论轻型卒中与非轻型卒中相比,病因学分型存在差异。轻型卒中小动脉闭塞病因占比更高,而非轻型卒中心源性栓塞及大动脉粥样硬化性病因占比更高。

     

    Abstract: Objective To investigate the differences in the etiology between minor stroke and non-minor stroke based on TOAST and ASCO systems, and to guide the early intervention for minor stroke. Methods We retrospectively analyzed the patients with acute ischemic stroke admitted to our department from July 2012 to July 2014. We sub-typed minor stroke patients and non-minor stroke patients in etiology using Trial of Org 10172 in Acute Stroke Treatment (TOAST) and ASCO (A for atherosclerosis, S for small vessel disease, C for Cardiac source, O for other cause) systems respectively to investigate the difference of etiology between the two groups. Results We included a total of 406 patients with minor stroke and 651 patients with non-minor stroke. The constituent ratio of TOAST was different (P<0.001) between the two groups. small-artery occlusion (SAO) was the highest cause (40.4%,164 cases) in minor stroke group, while stroke undertermined etiology (SUE)was the most common (30.9%,201 cases)in non-minor stroke group. The A1+2 ratio and C1+2 ratio in minor stroke group were lower than those in non-minor stroke group (22.8% vs. 35.4%, P<0.001; 19.3% vs. 32.1%, P<0.001), and the ratio of S1+2 was higher than that in non-minor stroke group (49.8% vs. 27.3%, P<0.001). Conclusion The etiology of minor stroke is different to non-minor stroke SAO is the most common cause in minor stroke, while CE and LAA are more common in non-minor stroke.

     

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