Objective To compare the pathogeny distribution of acute ischemic stroke between young adults and the aged by using the classification method of Chinese ischemic stroke subclassification( CISS)and to provide references for the clinical treatment. Methods We enrolled 210 patients aged 18 to 44 with acute ischemic stroke who were admitted into Beijing Anzhen Hospital affiliated to Capital Medical University from January 2004 to December 2013 and assigned them into the young group. And another 190 patients aged no less than 45 with acute ischemic stroke who were admitted into the same hospital in the same period were enrolled and assigned into the middle-aged and senior group. The general data and laboratory examination results of the patients were collected and classified the pathogeny distribution of patients with acute ischemic stroke according to CISS classification method. Results The two groups were significantly different(χ2 =33. 188,P<0. 001)in the distribution of CISS. The 77 LAA patients in the young group all had intracranial and extracranial large artery atherosclerosis,and among the 93 LAA subjects in the middle-aged and senior group,91 had intracranial and extracranial large artery atherosclerosis. The two groups were significantly different(χ2 =8. 008,P <0. 05)in the distribution of intracranial and extracranial large artery atherosclerosis. The two groups were significantly different( u= -3. 186,-12. 280,-15. 305,-15. 246,-11. 588,-12. 492,-14. 130;P <0. 05)in the stenosis degree of internal carotid artery,vertebral artery,subclavian artery,basilar artery,anterior cerebral artery, the middle cerebral artery and posterior cerebral artery. The two groups were significantly different(χ2 =18. 840,P<0. 05)in pathogeny distribution of CS. Conclusion The young adults with acute cerebral infarction by CISS is LAA,and intracranial and extracranial large artery atherosclerosis is most common pathogeny of LAA. Young patients are different from middle-aged and senior in stenosis degree of intracranial and extracranial artery.%目的：采用中国缺血性卒中亚型（ CISS）分型方法，比较青年与中老年急性缺血性卒中患者病因分布的差异，为临床治疗提供依据。方法选取2004年1月—2013年12月于首都医科大学附属北京安贞医院住院治疗的18～44岁急性缺血性卒中患者210例为青年组，按照相近的性别构成随机抽取同期年龄≥45岁的急性缺血性卒中患者190例为中老年组，收集患者一般资料和实验室检查结果，按照CISS分型方法对患者急性缺血性卒中病因进行分型。结果青年组和中老年组CISS分型分布比较，差异有统计学意义（χ2=33.188，P<0.001）。青年组77例大动脉粥样硬化（ LAA）患者均为颅内外大动脉粥样硬化，中老年组93例LAA患者中91例为颅内外大动脉粥样硬化，两组颅内外大动脉粥样硬化类型分布比较，差异有统计学意义（χ2=8.008，P<0.05）。青年组和中老年组颈内动脉、椎动脉、锁骨下动脉、基底动脉、大脑前动脉、大脑中动脉和大脑后动脉狭窄程度比较，差异均有统计学意义（ u=-3.186，-12.280，-15.305，-15.246，-11.588，-12.492，-14.130；P<0.05）。两组心源性卒中（ CS）患者病因分布比较，差异有统计学意义（χ2=18.840，P<0.05）。结论青年急性脑梗死CISS分型以LAA为主，而LAA又以颅内外大动脉粥样硬化为主。青年患者颅内外动脉狭窄程度与中老年患者不同。
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