短暂性脑缺血发作患者短期预后的影响因素分析Analysis of risk factors on the short-term prognosis of patients with transient ischemic attack
刘胜武;吴瑞;
摘要(Abstract):
目的对短暂性脑缺血发作患者短期预后的影响因素进行分析。方法选择60例短暂性脑缺血发作患者为研究对象,选取3个月作为时间点,观察患者3个月内的疾病进展情况,对影响患者预后的相关因素进行分析。结果 (1)随访3个月,DWI正常者中10例发生脑卒中,发生率23.8%,而DWI异常者中8例发生脑卒中,发生率57.1%,2组脑卒中发生率比较,差异有统计学意义(P<0.05);(2)脑卒中组9例发病前有糖尿病史,13例有脑血管疾病史;而无脑卒中组发病前10例有糖尿病,16例有脑血管疾病,2组比较差异有统计学意义(P<0.05)。2组高脂血症、心血管疾病史及吸烟、饮酒等危险因素与脑卒中发生情况比较,差异无统计学意义(P>0.05)。结论脑血管疾病及糖尿病史是TIA患者发生脑卒中的危险因素,DWI异常的TIA患者发生脑卒中的风险较大。
关键词(KeyWords): 短暂性脑缺血发作;短期预后;危险因素
基金项目(Foundation):
作者(Authors): 刘胜武;吴瑞;
参考文献(References):
- [1]Rothwe UPM,Giles MF,Flessmarm E,et al.A simple score(ABCD)to identify individuals at hilgh early risk of stroke after transient ischemic attack[J].Lancet,2005,366(1):29-36.
- [2]Yang J,Fu JH,Chen XY,et al.Validation of the ABCD2score to identify the patients with high risk of late stroke after a transient ischemic attack or minor ischemic stroke[J].Stroke,2010,41(3):1 298-1 300.
- [3]Touze E,Varenne O,Chatellier G,et al.Risk of myocardial infarction and vaseular death after transient ischemic attack and ischemie stroke:a systematic review and meta-analysis[J].Stroke,2005,36(2):2 748-2 755.
- [4]Takahashi PY,Dyrbye LN,3boreas KG,et al.The association of transient ischemic attack symptoms with memm'y impaim-ut among elderly participants of the Third US National Health and Nutrition Examination Survey[J].Geriatr Psychiatry Neurel,2009,22(2):46-51.
- [5]Jagoda A,Chan YF.Transient ischemic attack overview:defining the challenges for improving outcomes[J].Ann Emerg Med,2008,52(3):S3-S6.
- [6]中华神经科学会中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
- [7]Marler JR,Tilley BC,Lu M,et al.Early stroke treatment associated with better outcome:The NINDS rt-PA Stroke Study[J].Neurology,2000,55(11):1 649-165.
- [8]刘鸣,谢鹏.神经内科学[M].北京:人民卫生出版社,2008:40.
- [9]Redgrave JN,Coutts SB,Schulz UG.Systematic review of associations between the presence of acute ischemic lesions on diffusionweighted imaging and clinical predictors of early stroke risk after transient ischemic attack[J].Stroke,2007,38(5):1 482-1 488.
- [10]Hill MD,Yiannakoulias N,Jeerakathil T,et al.The high risk of stroke immediately after transient ischemic attacks:apopulation-based study[J].Neurology,2004,62(8 Suppl 6):s2 015.
- [11]Rothwell PM,Warlow CP.Timing of TIAs preceding stroke:time window for prevention is very short[J].Neurology,2005,64(6):817.
- [12]唐晓科,杨弘文.TIA短期内进展型脑梗死的危险因素分析[J].神经疾病与精神卫生,2008,8(5):366-367.
- [13]李书生.短暂性脑缺血发作患者短期预后及相关危险因素的研究[J].中国医药指南,2008,6(19):39-40.