目的：探讨儿童脑卒中发病的相关危险性因素。方法回顾性分析2006年1月至2014年1月收治的159例脑卒中患儿的临床资料。结果159例脑卒中患儿中，男100例、女59例，发病年龄中位数1.8岁(1 d~12岁)，高峰发病年龄中位数为0.9岁(3个月~2.8岁)。首发症状以肢体偏瘫、语言障碍和惊厥为主。常见危险因素为：感染46例(中枢神经系统感染32例，呼吸道及消化道感染14例)，头部外伤42例，维生素K缺乏29例，烟雾病8例，心脏疾病11例，自发性出血11例，不明原因12例。儿童急性缺血性脑卒中(AIS)以感染性疾病为主，好发年龄为幼儿期；而出血性脑卒中(HS)以维生素K1缺乏为主，好发年龄为婴儿期。头颅影像检查以基底节病灶及大脑中动脉受累最常见。确诊时间中位数为1.4 d；住院时间中位数为28 d；病情高峰时间中位数为4.3 d。结论 AIS是儿童脑卒中的常见类型，感染和头部外伤是主要危险因素，维生素K缺乏仍是引起婴儿HS的最常见因素。%Objective To analyze the potential etiologies and risk factors of childhood stroke. Methods This study retrospectively reviewed the clinical data of 159 children who were admitted from Jan.2006 to Jan.2014. Results The 159 children were composed of 100 boys and 59 girls , with median onset age of 1.8 years (ranged from 1 day to 12 years old) and median peak age of 0.9 years (ranged from 3 months to 2.8 years old). Their initial symptoms included limb hemiplegia,language dififculties and convulsion. The common causes included infections found in 46 cases (central nervous system infection in 32 cases, respiratory and gastrointestinal tract infection in 14 case), head injury in 42 cases, vitamin K deifciency in 29 cases, Moyamoya disease in 8 cases, heart diseases in 11 cases, spontaneous hemorrhage in 11 cases and 12 cases of unknown reason. Infectious diseases were the most common cause of children acute ischemic stroke in toddler period;and vitamin K1 deifciency were the most common cause of children hemorrhage stroke in infancy. The most common region of infarction is basal ganglia and middle cerebral artery in neuronal imaging. The median age at the time of diagnosis was 1.4 days. The median time of inhospital was 28 days. The median apex time was 4.3 days. Conclusions Among 159 cases, acute ischemic stroke is much more common than hemorrhagic stroke in children stroke, and the major risk factors are infections and head injury;Vitamin K1 deifciency is a major risk factor in infants with hemorrhagic stroke.
展开▼
