BACKGROUND & AIMS: :Anxiety and depression for 399 survivors of a 1,102-member heart disease cohort were assessed 8 to 9 years post-hospitalization. Approximately one-third reported symptoms of emotional distress and one-fourth were on anti-anxiety drugs. Predictors of anxiety and depression were analyzed through logistic regression. Subjects age 65 and over were less likely than younger patients to report anxiety or depression and also reported less heart-associated disability, the strongest predictor of distress for both age groups. Other significant predictors included a previous history of distress, low income, female sex, and beta blocker use.

背景与目标： : 住院后8至9年评估了一个由1,102名成员组成的心脏病队列的399幸存者的焦虑和抑郁。大约3分之1个报告的情绪困扰和4分之1症状是使用抗焦虑药物。通过logistic回归分析焦虑和抑郁的预测因子。与年轻患者相比，65岁及以上的受试者报告焦虑或抑郁的可能性较小，并且与心脏相关的残疾也较少，这是两个年龄组中困扰的最强预测指标。其他重要的预测因素包括以前的困扰史，低收入，女性性别和使用 β 受体阻滞剂。

BACKGROUND & AIMS: :Age-related changes in brain function are complex. Although ageing is associated with a reduction in cerebral blood flow and neuronal activity, task-related processing is often correlated with an enlargement of the corresponding and additionally recruited brain areas. This supplemental employment is considered an attempt to compensate for deficits in the ageing brain. Although there are contradictory reports regarding the role of the primary somatosensory cortex (SI), currently, there is little knowledge about age-related functional changes in other brain areas in the somatosensory network (secondary somatosensory cortex (SII), and insular, anterior (ACC) and posterior cingulate cortices (PCC)). We investigated 16 elderly (age range, 62-71 years) and 18 young subjects (age range, 21-28 years) by determining the current perception threshold (CPT) and applying functional magnetic resonance imaging (fMRI) using a 3.0 Tesla scanner under tactile stimulation of the right hand. CPT was positively correlated with age. fMRI analysis revealed significantly increased activation in the contralateral SI and ipsilateral motor cortex in elderly subjects. Furthermore, we demonstrated age-related reductions in the activity in the SII, ACC, PCC, and dorsal parts of the corpus callosum. Our study revealed dramatic age-related differences in the processing of a simple tactile stimulus in the somatosensory network. Specifically, we detected enhanced activation in the contralateral SI and ipsilateral motor cortex assumingly caused by deficient inhibition and decreased activation in later stages of somatosensory processing (SII, cingulate cortex) in elderly subjects. These results indicate that, in addition to over-activation to compensate for impaired brain functions, there are complex mechanisms of modified inhibition and excitability involved in somatosensory processing in the ageing brain.

背景与目标： : 与年龄相关的脑功能变化是复杂的。尽管衰老与脑血流量和神经元活动减少有关，但与任务相关的处理通常与相应和额外招募的大脑区域的扩大有关。这种补充就业被认为是弥补大脑老化缺陷的一种尝试。尽管关于初级体感皮层 (SI) 的作用有相互矛盾的报道，但目前，关于体感网络中其他大脑区域 (次级体感皮层 (SII) 和岛状，前部 (ACC) 和后部扣带回 (PCC))。我们通过确定当前感知阈值 (CPT) 并使用3.0特斯拉扫描仪在右手的触觉刺激下应用功能磁共振成像 (fMRI)，调查了16位老年人 (年龄范围，62-71岁) 和18位年轻受试者 (年龄范围，21-28岁)。CPT与年龄呈正相关。fMRI分析显示，老年受试者对侧SI和同侧运动皮层的激活显着增加。此外，我们证明了与年龄相关的SII，ACC，PCC和call体背侧活动的减少。我们的研究揭示了体感网络中简单触觉刺激处理过程中与年龄相关的显着差异。具体来说，我们检测到对侧SI和同侧运动皮层的激活增强，假定是由于老年受试者的体感加工 (SII，扣带回皮层) 后期的抑制不足和激活减少所致。这些结果表明，除了过度激活以补偿大脑功能受损外，衰老大脑的体感过程还涉及改良的抑制和兴奋性的复杂机制。

BACKGROUND & AIMS: BACKGROUND:in men, the concomitant use of two or more benzodiazepines or two or more antipsychotics is associated with an increased risk of fracture(s). Potential associations between the concomitant use of drugs with central nervous system effects and fracture risk have not been studied. OBJECTIVE:the purpose was to describe the gender-specific risk of fractures in a population aged 65 years or over associated with the use of an opioid, antiepileptic or anticholinergic drug individually; or, their concomitant use with each other; or the concomitant use of one of these with a psychotropic drug. METHODS:this study was part of a prospective, population-based study performed in Lieto, Finland. Information about fractures in 1,177 subjects (482 men and 695 women) was confirmed with radiology reports. RESULTS:at 3 years of follow-up, the concomitant use of an opioid with an antipsychotic was associated with an increased risk of fractures in men. During the 6-year follow-up, the concomitant use of an opioid with a benzodiazepine was also related to the risk of fractures for males. No significant associations were found for females. CONCLUSION:the concomitant use of an opioid with an antipsychotic, or with a benzodiazepine may increase the risk of fractures in men aged 65 years and older.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Frequent germ line cells mutations were previously demonstrated to be associated with aging. This suggests a higher incidence of childhood cancer among children of older parents. A population-based cohort study of parental ages and other prenatal risk factors for five main childhood cancers was performed with the use of a linkage between several national-based registries. METHODS:In total, about 4.3 million children with their parents, born between 1961 and 2000, were included in the study. Multivariate Poisson regression was used to obtain the incidence rate ratios (IRR) and 95% confidence interval (CI). Children <5 years of age and children 5-14 years of age were analysed independently. RESULTS:There was no significant result for children 5-14 years of age. For children <5 years of age, maternal age were associated with elevated risk of retinoblastoma (oldest age group's IRR = 2.39, 95%CI = 1.17-4.85) and leukaemia (oldest age group's IRR = 1.44, 95%CI = 1.01-2.05). Paternal age was significantly associated with leukaemia (oldest age group's IRR = 1.31, 95%CI = 1.04-1.66). For central nervous system cancer, the effect of paternal age was found to be significant (oldest age group's IRR = 1.69, 95%CI = 1.21-2.35) when maternal age was included in the analysis. CONCLUSION:Our findings indicate that advanced parental age might be associated with an increased risk of early childhood cancers.

背景与目标：

BACKGROUND & AIMS: PURPOSE:To identify the relationship between epidermal growth factor (EGF) concentration in human tears and clinical tear-flow parameters and how these vary with age and gender.

METHODS:Tear samples were collected with minimal stimulation from 68 healthy and asymptomatic adults (33 men, 35 women), aged 21-88 years. EGF concentrations were determined by sandwich enzyme-linked immunosorbent assay (ELISA) in 65 cases. Schirmer tests were performed without anesthesia, and the clearance of fluorescein from the tear film assessed. The Tear Function Index (TFI) was calculated from these values.

RESULTS:There were approximately equal numbers of male and female subjects with a similar age distribution for each gender (48 +/- 3 and 51 +/- 3 years, mean +/- SEM, respectively). Ninety percent of tear EGF concentrations were between 0.75 and 7.1 ng/ml. Tear EGF level correlated significantly with Schirmer I value, but not with age. Schirmer I value correlated with tear clearance [LN(TCR)] but not with age. Tear EGF concentrations were significantly higher for men (3.4 +/- 0.3 ng/ml) than for women (2.4 +/- 0.3 ng/ml; p = 0.043).

CONCLUSIONS:EGF concentrations is tear samples from normal humans were found to correlate with gender and Schirmer I value but not with tear clearance.

背景与目标： 目的 : 确定人眼泪中表皮生长因子 (EGF) 浓度与临床泪液流量参数之间的关系，以及这些参数随年龄和性别的变化。
方法 : 在最小的刺激下，从68名健康和无症状的成年人 (33名男性，35名女性) 收集了眼泪样本，年龄在21-88岁之间。用夹心酶联免疫吸附法 (ELISA) 测定65例患者的EGF浓度。在没有麻醉的情况下进行Schirmer测试，并评估了泪膜中荧光素的清除率。泪液功能指数 (TFI) 是根据这些值计算得出的。
结果 : 每个性别年龄分布相似的男性和女性受试者数量大致相等 (48/- 3岁和51/- 3岁，分别为平均值 +/- SEM)。90% 的泪液EGF浓度在0.75至7.1 ng/ml之间。泪液EGF水平与Schirmer I值显着相关，但与年龄无关。Schirmer I值与泪液清除率 [LN(TCR)] 相关，但与年龄无关。男性的泪液EGF浓度 (3.4/- 0.3 ng/ml) 显着高于女性 (2.4/- 0.3 ng/ml; p = 0.043)。
结论 :EGF浓度是正常人的泪液样本与性别和Schirmer I值相关，但与泪液清除率无关。

BACKGROUND & AIMS: This report describes a 91-year-old patient with patent ductus arteriosus (PDA) complicated by combined valvular disease (CVD) (aortic and mitral stenosis, and aortic, mitral, pulmonic and tricuspid regurgitation). This patient seems to be the oldest living female with PDA and CVD hitherto reported in the medical literature. The patient developed several bouts of congestive heart failure which were treated medically. She not only has survived without surgical management, but is still enjoying her life at age 91. The features of PDA in the elderly are reviewed.

背景与目标： 该报告描述了一名91岁的动脉导管未闭 (PDA) 合并合并瓣膜疾病 (CVD) (主动脉和二尖瓣狭窄以及主动脉，二尖瓣，肺动脉和三尖瓣反流) 的患者。该患者似乎是迄今为止医学文献中报道的患有PDA和CVD的最年长的女性。该患者出现了几次充血性心力衰竭，并接受了医学治疗。她不仅在没有手术治疗的情况下幸存下来，而且还在享受91岁的生活。回顾了老年人PDA的功能。

BACKGROUND & AIMS: OBJECTIVE:The aim of this study was to assess the relative influence of age and edentulousness upon mandibular bone mineral density (BMD) in a sample of dentate and edentulous female subjects. STUDY DESIGN:Seventy-two patients (43-79 years of age; mean age, 62.5 years), of whom 49 were edentulous and 23 dentate, underwent dual x-ray energy absorptiometry (DXA) to determine the BMD of the body of mandible. Mandibular BMD was measured using DXA. The investigators independently determined rectangular regions of interest (ROIs) on the mandibular images, and the computer calculated the BMD of these specified regions. For the dentate patients, the ROIs were placed to exclude the roots of teeth. RESULTS:A linear multiple regression model was fitted to the dependent variable, mandibular body BMD, with age and whether the patient was edentulous or dentate being explanatory factors in the statistical model. The variable describing the dentate/edentulous state was not significant in the statistical model (P = .91). The model showed that age was significantly related negatively to the BMD of the mandibular body (P = .01). CONCLUSION:Age was a predictor of mandibular BMD but edentulousness was not.

背景与目标：

BACKGROUND & AIMS: :Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis with a very poor prognosis. We aimed at assessing risk factors related to the prognosis of patients with TBM.Forty-five inpatients with TBM in our institution from January 2013 to December 2015 were enrolled retrospectively. The good or poor prognosis in the patients was defined, based on Glasgow Outcome Scale System at discharge. Patients with a GOS score less than 5 were defined as "poor prognosis." Univariate and multivariate logistic regression analyses were performed to assess the predictors for TBM outcome.Among 45 TBM patients, 35 (77.8%) and 10 (22.2%) were in good, poor prognoses, respectively. Old age, disturbance of consciousness, moderate to severe electroencephalogram abnormality, hydrocephalus, remarkable increase of protein (≥ 236 mg/dL) and white blood cell counts (≥ 243 /μL) in cerebral spinal fluid were associated with poor prognosis. Multivariate analysis indicated that old age (odds ratio (OR) = 18.395, P = .036) and hydrocephalus (OR = 32.995, P = .049) were independent factors for a poor outcome of TBM.In conclusion, old age and hydrocephalus are the predictors for poor prognosis of TBM. Patients with these risk factors should be treated promptly with a special care paid to improve their outcomes.

背景与目标： 结核性脑膜炎 (TBM) 是中枢神经系统结核病的最常见形式，预后很差。我们旨在评估与TBM患者预后相关的危险因素。我们机构从2013年1月到2015年12月的45例TBM住院患者被回顾性纳入。根据出院时格拉斯哥结局量表系统，确定了患者的良好或不良预后。GOS评分小于5的患者被定义为 “不良预后”。进行单因素和多因素logistic回归分析以评估TBM结果的预测因素。在45例TBM患者中，分别有35例 (77.8% 例) 和10例 (22.2% 例) 预后良好。年龄大、意识障碍、中重度脑电图异常、脑积水、脑脊液中蛋白质 (≥ 236  mg/dL) 和白细胞计数 (≥ 243  /μ l) 均与预后不良相关。多因素分析显示，高龄 (优势比 (OR)  =   18.395，p   =  .036) 和脑积水 (OR   =   32.995，p   =  .049) 是TBM预后不良的独立因素。老年和脑积水是TBM预后不良的预测因素。具有这些危险因素的患者应及时接受特殊护理治疗，以改善其预后。

BACKGROUND & AIMS: INTRODUCTION:New diagnostic tools such as the retinal thickness analyzer (RTA), optical coherence tomography (OCT), and topographic angiography (TAG) were introduced into clinical ophthalmology during the last years giving the examiner new insights into anatomical and functional aspects of macular disease. In this study, advantages and disadvantages of the new imaging methods have been evaluated in patients with serous (sPED) and fibrovascular pigment epithelial detachments (fPED) secondary to age-related macular degeneration (AMD). METHODS:TAG, using fluorescein angiography (FA), provides a three-dimensional profile of the fluorescein pattern based on the analysis of a set of 32 confocal images over a depth of 4 mm. RTA and OCT provide cross-sectional images of the neurosensory retina and the retinal pigment epithelium-choriocapillary complex as well as retinal thickness data encoded in a false color map. We compared and evaluated these modalities in 15 patients with fPED and 15 patients with sPED secondary to AMD. RESULTS:In patients with classic fPED, TAG detected neovascular structures and delineated their configuration. In sPEDs, pooling of extravascular fluid was detected in a dome-shaped configuration. OCT provided detailed information on the neurosensory retina's structures but failed to detect the neovascular membrane in fPED. Mapping the retinal thickness, RTA and OCT both failed to detect the PED and showed typical algorithm error-based patterns. CONCLUSION:TAG OCT and RTA are useful imaging modalities in the evaluation of AMD cases. TAG visualizes the vascular configuration, dynamic perfusion, and leakage changes. OCT and RTA are able to complementarily document intra-, subretinal, and sub-RPE fluid accumulation secondary to CNV. However, OCT seems to be more efficient in imaging AMD-related pathologies than RTA, as this modality is often compromised by intra- or subretinal structural abnormalities. Nevertheless, all modalities may provide further valuable insight into AMD pathogenesis, enhance diagnostic quality, and improve the assessment of therapeutic effects.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The incidence of rectal cancer in patients ≤ 50 years of age is increasing. The response to neoadjuvant treatment in patients ≤ 50 years of age is not known. Factors affecting the response to neoadjuvant therapy in this age group have not been evaluated. OBJECTIVE:This study aims to evaluate the rate and identify factors that affect pathologic response to neoadjuvant therapy in patients with early age-of-onset rectal cancer. DESIGN:This study is a retrospective review. SETTING:The investigation was conducted at a tertiary-care cancer referral center. PATIENTS:Included were 193 consecutive patients ≤ 50 years of age with rectal cancer who underwent neoadjuvant therapy followed by surgical resection. INTERVENTIONS:No interventions were performed. MAIN OUTCOME MEASURES:The primary outcome measured was the pathologic response to neoadjuvant treatment. RESULTS:The median age was 44 years, and 34% of the patients were female. The median distance from the anal verge was 7 cm. The median percentage of lumen occupied by tumor was 50%. The median CEA level was 3.5 ng/mL. The median treatment response was 80%. The mean number of lymph nodes examined was 15 per patient. Twenty-two percent of patients had a complete or near-complete (≥ 95%) response to neoadjuvant treatment. Seventy-seven percent of evaluable patients experienced tumor or lymph node downstaging on pathologic examination. The presence of adverse histologic features, percentage of lumen occupied by tumor, and CEA level differed between those with <95% response and those with ≥ 95% response to neoadjuvant therapy, although CEA level was not significant when stage IV patients were excluded. LIMITATIONS:This is a retrospective review with heterogeneity in workup, treatment regimens, and interval to surgery. Long-term oncologic outcomes are not available. CONCLUSIONS:The rate of response to neoadjuvant treatment appears similar in patients with early age-of-onset rectal cancer to non-age-based cohorts in the literature. Adverse histologic features and bulky circumferential tumors may be suggestive of a decreased response to neoadjuvant therapy.

背景与目标：

BACKGROUND & AIMS: :A rapid elevation in the level of endogenous corticosterone (CORT) functions in the stress response associated with the hypothalamus-pituitary-adrenal axis, and it has been well documented that high levels of CORT play neurotoxic roles in the hippocampus. Both aging and the circadian rhythm possibly affect the sensitivity to CORT, although their endogenous modifications in the CORT-mediated events remain unclear. To explore the influence of age or circadian time on hippocampal vulnerability to excess CORT, we examined the relative mRNA expression of bcl-2 and bax in the dentate gyrus (DG) and the CA1 subfield, compared with the CA3 as an internal standard, after acute CORT administration using in situ RT-PCR. Male rats aged 10 weeks (young) or 6 months (adult) were treated with CORT at 0800 or 2000 h. The bcl-2 to bax mRNA ratio in the dentate gyrus (DG) was significantly decreased 2h after CORT exposure in the young rats treated at 0800 or 2000 h. In the adult rats, the treatment with CORT at 0800 h significantly decreased the bcl-2 to bax ratio, whereas the treatment at 2000 h was ineffective; the discrepancy between the treatment time points was apparent in adult rats, but not in young rats. Our results emphasize the importance of circadian time as well as age as a factor influencing the stress paradigm.

背景与目标： : 与下丘脑-垂体-肾上腺轴相关的应激反应中内源性皮质酮 (CORT) 功能的水平迅速升高，并且已充分证明高水平的CORT在海马中起神经毒性作用。衰老和昼夜节律都可能影响对CORT的敏感性，尽管它们在CORT介导的事件中的内源性修饰仍不清楚。为了探讨年龄或昼夜节律时间对海马对过量CORT易感性的影响，我们检查了齿状回 (DG) 和CA1子场中bcl-2和bax的相对mRNA表达，与CA3作为内标进行比较。使用原位rt-pcr给药。在0800或2000小时用CORT治疗10周 (年轻) 或6个月 (成年) 的雄性大鼠。在0800或2000小时处理的幼鼠中，CORT暴露后2小时，齿状回 (DG) 中的bcl-2与bax mRNA比率显着降低。在成年大鼠中，在0800 h用CORT处理显着降低了bcl-2与bax的比率，而在2000 h处理无效; 在成年大鼠中，治疗时间点之间的差异很明显，但在幼鼠中却没有。我们的结果强调了昼夜节律时间以及年龄作为影响压力范式的因素的重要性。

BACKGROUND & AIMS: PURPOSE:To report the secondary outcomes in the Carotenoids with Coantioxidants in Age-Related Maculopathy trial. DESIGN:Randomized double-masked placebo-controlled clinical trial (registered as ISRCTN 94557601). PARTICIPANTS:Participants included 433 adults 55 years of age or older with early age-related macular degeneration (AMD) in 1 eye and late-stage disease in the fellow eye (group 1) or early AMD in both eyes (group 2). INTERVENTION:An oral preparation containing lutein (L), zeaxanthin (Z), vitamin C, vitamin E, copper, and zinc or placebo. Best-corrected visual acuity (BCVA), contrast sensitivity (CS), Raman spectroscopy, stereoscopic colour fundus photography, and serum sampling were performed every 6 months with a minimum follow-up time of 12 months. MAIN OUTCOME MEASURES:Secondary outcomes included differences in BCVA (at 24 and 36 months), CS, Raman counts, serum antioxidant levels, and progression along the AMD severity scale (at 12, 24, and 36 months). RESULTS:The differential between active and placebo groups increased steadily, with average BCVA in the former being approximately 4.8 letters better than the latter for those who had 36 months of follow-up, and this difference was statistically significant (P = 0.04). In the longitudinal analysis, for a 1-log-unit increase in serum L, visual acuity was better by 1.4 letters (95% confidence interval, 0.3-2.5; P = 0.01), and a slower progression along a morphologic severity scale (P = 0.014) was observed. CONCLUSIONS:Functional and morphologic benefits were observed in key secondary outcomes after supplementation with L, Z, and coantioxidants in persons with early AMD.

背景与目标：

BACKGROUND & AIMS: :This study is a secondary data analysis from the National Health Morbidity Survey III, a population-based study conducted in 2006. A total of 7,749 children between 7 and 12 years old were recruited into the study. This study seeks to report the prevalence of overweight (including obesity) children in Malaysia using international cut-off point and identify its associated key social determinants. The results show that the overall prevalence of overweight children in Malaysia was 19.9%. The urban residents, males, Chinese, those who are wealthy, have overweight or educated guardians showed higher prevalence of overweight. In multivariable analysis, higher likelihood of being overweight was observed among those with advancing age (OR=1.15), urban residents (OR=1.16, 95% CI: 1.01-1.36), the Chinese (OR=1.45, 95% CI: 1.19-1.77), boys (OR=1.23, 95% CI: 1.08-1.41), and those who came from higher income family. In conclusion, one out of five of 7-12 year-old-children in Malaysia were overweight. Locality of residence, ethnicity, gender, guardian education, and overweight guardian were likely to be the predictors of this alarming issue. Societal and public health efforts are needed in order to reduce the burden of disease associated with obesity. :本研究採用2006 年馬來西亞全國第三次健康及疾病調查(National Health Morbidity Survey III)的二手資料，這個調查是根據人口抽樣的。共有 7,497 位，年齡介於7-12 歲的兒童納入研究。本研究目的在報告採用國際切 點時，馬來西亞過重(包括肥胖)兒童的盛行率，並確定其相關的主要社會決定 因素。結果顯示，馬來西亞整體兒童過重盛行率為19.9%。居住在城市、男 性、華裔、較富有的、家長為過重或受過教育的，這些兒童顯示有較高的過 重盛行率。在多元分析中發現， 過重的情況較可能發生在： 較年長 (OR=1.15)、居住在城市(OR= 1.16，95％CI: 1.01-1.36)、華裔(OR= 1.45，95％ CI: 1.19 -1.77)、男孩(OR= 1.23，95％CI: 1.08-1.41)、及來自高收入家庭的孩 童。結論是，馬來西亞7-12 歲的孩童中，5 位中就有1 位為體重過重。居住 地、種族、性別、家長教育程度和過重的家長，可能是此要提高警訊的議題 之預測因子。為了減少與肥胖相關的疾病負擔，社會和公共衛生的努力是必 要的。

背景与目标：

BACKGROUND & AIMS: :The effect of intravenous thrombolysis (IVT) according to etiology and stroke severity in young patients with ischemic stroke (IS) has not been described previously. To analyze the effect of IVT in young patients with IS according to etiological subtype and stroke severity. Observational study with inclusion of IS patients under 55 years of age (2007-2012). Two groups were compared according to IVT treatment. Favorable outcomes were defined as 3 months modified Rankin Scale ≤2. Multivariate analyses were performed to determine those factors independently associated with favorable outcomes, and subgroup analyses were conducted to assess the effect of IVT according to etiological stroke subtype and severity on admission, adjusted for other prognostic variables. We evaluated 262 patients. 63 (24%) received IVT. The mean age and the sex distribution were similar in the IVT treated and the non-treated groups. Multivariate analyses showed that IVT was associated with a higher probability of favorable outcome (OR, 95% CI: 4.652, 1.294-16.722) whereas artery dissection (OR, 95% CI: 0.191, 0.056-0.654) and NIHSS (OR, 95% CI: 0.727, 0.664-0.797) were associated with a lower probability of a favorable outcome. The subgroup analysis showed that the beneficial effect of IVT on outcomes was significant in moderate-severe strokes (NIHSS ≥8) (OR, 95% CI: 3.782, 1.095-13.069) and in cardioembolism (OR, 95% CI: 41.887, 1.001-1751.596). In IS patients under 55 years of age, those with moderate-severe strokes benefit more from IVT than those with mild strokes. Cardioembolic infarctions may benefit more from IV tPA than other etiologies.

背景与目标： : 根据病因和中风严重程度，静脉溶栓 (IVT) 对年轻缺血性中风 (IS) 患者的影响以前尚未描述。根据病因亚型和卒中严重程度分析IVT对年轻IS患者的影响。纳入55岁以下IS患者的观察性研究 (2007-2012)。根据IVT治疗，对两组进行比较。良好的结局定义为3个月改良Rankin量表 ≤ 2。进行多变量分析以确定与良好结局独立相关的那些因素，并进行亚组分析以根据病因卒中亚型和入院严重程度评估IVT的影响，并根据其他预后变量进行校正.我们评估了262名患者。63 (24%) 收到IVT。IVT治疗组和非治疗组的平均年龄和性别分布相似。多变量分析显示，IVT与较高的有利结果概率相关 (OR，95% CI: 4.652，1.294-16.722)，而动脉夹层 (OR，95% CI: 0.191，0.056-0.654) 和NIHSS (OR，95% CI: 0.727，0.664-0.797) 与良好结果的可能性较低相关。亚组分析显示，在中度-重度卒中 (NIHSS ≥ 8) (OR，95% CI: 3.782，1.095-13.069) 和心脏栓塞 (OR，95% CI: 41.887，1.001-1751.596) 中，IVT对结局的有益作用是显著的。在55岁以下的IS患者中，中重度中风患者比轻度中风患者从IVT中受益更多。与其他病因相比，静脉tPA可使心脏栓塞梗塞受益更多。

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