OBJECTIVES This study aimed to analyze the risk factors of ischemic stroke in young adults of different ages; explore the changes in these risk factors with time; analyze the clinical characteristics of ischemic stroke in young adults; and assess how to better prevent ischemic stroke in young adults. METHODS All patients with ischemic stroke who presented to the Department of Emergency Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School were enrolled. The data of patients aged 18-50 years were retrospectively evaluated for two periods, January-December 2008 and January-December 2018. Additionally, we collected the data of patients aged 51-90 years with ischemic stroke in the same ward in 2018. The subjects were divided into three groups: ischemic stroke in young people in 2008 ("Youth 2008"), ischemic stroke in young people in 2018 ("Youth 2018"), and ischemic stroke in elderly people in 2018 ("Senior 2018"). Risk factors, clinical characteristics and test indices were recorded and analyzed statistically. RESULTS The "Youth 2008" group included 28 patients-19 males (67.9%) and 9 females (31.2%) with a male-to-female ratio of 2.11:1. The "Youth 2018" group included 23 patients-20 males (87.0%) and 3 females (13.0%) with a male-to-female ratio of 6.67:1. The "Senior 2018" group included 210 patients-150 males (71.4%) and 60 females (28.6%) with a male-to-female ratio of 2.50:1. The risk factors in "Youth 2018" were higher than those in "Youth 2008" in terms of hypertension, hyperglycemia, and hypercholesterolemia without significant difference. Smoking and hypertrophic cardiomyopathy were significantly increased (P < 0.05) in this population. Smoking, hypercholesterolemia, and hypertrophic cardiomyopathy were more prevalent among the "Youth 2018" group than among the "Senior 2018" group, whereas carotid plaques, hypertension, and atrial fibrillation were less common in the younger group (P < 0.05). There was no significant difference between the younger and older groups in terms of thrombolysis rate, cerebral infarction type, and complications, except pulmonary infections (P < 0.05). CONCLUSIONS There was no significant change in the main risk factors of ischemic stroke in young adults during the 10-year period. Traditional risk factors-smoking and hypertrophic cardiomyopathy-were still common but with a significantly greater prevalence, whereas carotid plaques, hypertension, and atrial fibrillation had become less common. The clinical characteristics, other than pulmonary infection, were not significantly different between the younger and older patients with ischemic stroke.

中文翻译：

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年轻人缺血性卒中的危险因素和临床特征的时间趋势。

目的本研究旨在分析不同年龄年轻人的缺血性中风的危险因素。探索这些风险因素随时间的变化；分析年轻人缺血性中风的临床特征；并评估如何更好地预防年轻人的缺血性中风。方法选择南京大学附属鼓楼医院，南京大学医学院附属医院急诊科就诊的缺血性脑卒中患者。在2008年1月至12月和2018年1月至12月这两个时期对18至50岁的患者数据进行回顾性评估。此外，我们于2018年在同一病房收集了51至90岁的缺血性卒中患者的数据。研究对象分为三组：2008年青少年缺血性卒中（“青年2008”），2018年（“ Youth 2018”）在年轻人中发生缺血性中风，2018年（“ Senior 2018”）在老年人中发生缺血性中风。记录危险因素，临床特征和测试指标并进行统计分析。结果“ 2008年青年”组包括28例患者，其中男19例（67.9％），女9例（31.2％），男女之比为2.11：1。“ Youth 2018”组包括23例患者，其中20例男性（87.0％）和3例女性（13.0％），男女比例为6.67：1。“ Senior 2018”组包括210名患者，其中150名男性（71.4％）和60名女性（28.6％），男女比例为2.50：1。在高血压，高血糖和高胆固醇血症方面，“青年2018”的危险因素高于“青年2008”。在该人群中，吸烟和肥厚型心肌病显着增加（P <0.05）。在“青年2018”组中，吸烟，高胆固醇血症和肥厚型心肌病比“ 2018年高级”组更普遍，而年轻组的颈动脉斑块，高血压和心房纤颤较少见（P <0.05）。两组之间在溶栓率，脑梗死类型和并发症方面没有显着差异，除了肺部感染（P <0.05）。结论在10年期间，年轻人缺血性卒中的主要危险因素没有显着变化。传统的危险因素-吸烟和肥厚型心肌病-仍然很常见，但患病率明显更高，而颈动脉斑块，高血压和心房纤颤已变得不那么普遍了。在年轻和老年缺血性卒中患者之间，除肺部感染外，临床特征无显着差异。