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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Clinical Impact of Thrombophilia Screening in Young Adults with Ischemic Stroke
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Clinical Impact of Thrombophilia Screening in Young Adults with Ischemic Stroke

机译：血管血管筛查在缺血性脑卒中的年轻成人中的临床影响

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Objective: We evaluated the ability of genetic and serological testing to diagnose clinically relevant thrombophilias in young adults with ischemic stroke. Methods: We performed a retrospective cohort study of patients aged 18-65 years diagnosed with acute ischemic stroke at a comprehensive stroke center between 2011 and 2015 with laboratory testing for thrombophilia. The primary outcome was any positive thrombophilia screening test. The secondary outcome was a change in clinical management based on thrombophilia testing results. Logistic regression was used to assess whether the prespecified risk factors of age, sex, prior venous thromboembolism, family history of stroke, stroke subtype, and presence of patent foramen ovale were associated with outcomes. Results: Among 196 young ischemic stroke patients, at least 1 positive thrombophilia test was identified in 85 patients (43%; 95% CI, 36%-51%) and 16 (8%; 95% CI, 5%-13%) had a resultant change in management. Among 111 patients with cryptogenic strokes, 49 (44%) had an abnormal thrombophilia test and 9 (8%) had a change in management. After excluding cases of isolated hyperhomocysteinemia or methylenetetrahydrofolate reductase or Factor V Leiden gene mutation heterozygosity, the proportion of patients with an abnormal thrombophilia screen decreased to 24%. Prespecified risk factors were not significantly associated with positive thrombophilia testing or a change in management. Conclusions: Two-of-five young patients with ischemic stroke who underwent thrombophilia screening at our institution had at least 1 positive test but only one-in-twelve had a resultant change in clinical management. Neither cryptogenic stroke subtype nor other studied clinical factors were associated with a prothrombotic state.
机译：目的：我们评估了遗传和血清学检测能力，以缺血性脑卒中诊断患者临床相关血栓药中的临床相关血栓药。方法：在2011年至2015年间综合中风中心诊断患有18-65岁患者的患者的回顾性队列研究，在2011年和2015年的综合中风中心进行血栓形成的实验室检测。主要结果是任何正血栓筛查试验。二次结果是基于血栓性测试结果的临床管理变化。 Logistic回归用于评估预先确定的年龄，性别，前静脉血栓栓塞，中风，中风亚型和专利脉络膜卵巢的存在的危险因素是否与结果有关。结果：196例年轻缺血性卒中患者中，85名患者中鉴定了至少1次阳性血栓检查试验（43％; 95％CI，36％-51％）和16（8％; 95％CI，5％-13％）得到了管理的改变。在111例隐生患者中，49例（44％）具有异常的血栓性试验，9（8％）有管理变化。在排除分离的高胱氨酸血症或亚甲基四氢溶胶还原酶或因子V leiden基因突变杂合的情况下，异常血栓性筛选患者的比例降至24％。预先发现的风险因素与阳性血栓性测试或管理变化没有显着相关。结论：二五名患有缺血性中风的年轻患者在我们的机构接受血栓性筛查筛查至少有1个阳性测试，但只有一甲基临床管理的发生变化。既不是密码发生的中风亚型也没有其他研究与普形细胞状态有关。

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