摘要
目的研究短暂性脑缺血发作(TIA)与急性缺血性卒中的关系。方法回顾性研究了306例急性缺血性中风患者。将患者分为有急性短暂性脑缺血发作史和无急性短暂性脑缺血发作史两组,比较两组患者之间的临床特点和预后情况并进行多元回归分析,确定病情预后的预测指标。结果 306例急性缺血性卒中患者,其中69例有TIA史。与没有TIA史组的患者相比,有TIA史组的患者发生高血压(76.4%比64.4%,P=0.017),血脂异常(57.1%比41.2%,P=0.004),慢性肾脏病(28.2%比15.2%,P=0.002),颅内动脉狭窄(51.9%比36.3%,P=0.019),大血管动脉粥样硬化(44.0%比28.4%,P=0.003)的比例更高。两组患者在发病之前使用的抗血栓药物差异无统计学意义(36.1%和35.3%,P=0.882)。有TIA史的患者的中风预后情况显著较差(改良Rankin量表评分≥4)。多元Logistic回归分析TIA病史是急性缺血性中风不良预后的独立预测因素之一(OR:1.47;95%CI:1.03-2.11,P=0.042)。结论有TIA史的患者较无TIA史的患者发生急性缺血性中风的风险更大。只有三分之一的患者在发生TIA后进行抗血栓治疗。
Objective To investigate the relationship between transient ischemic attack （TIA）and acuteischemic stroke. Methods We retrospectively studied 306 cases of patients with acute ischemic stroke. According to the history of TIA, patients were divided into two groups. Clinical features and prognosis were compared between the two groups by the multiple regression analysis to determine the predictors of disease prognosis. Results Among 306 cases of patients with acute ischemic stroke included in our study,69 cases of patients were with the history of TIA. Compared with patients without TIA history,patients with TIA history were more likely to have hypertension（76. 4% vs 64.4% ,P=0. 017） ,dyslipidemia（57.1% vs 41.2% ,P=0. 004） ,chronic kidney disease（28.2% vs 15.2% ,P =0. 002） ,intracranial arterial stenosis（51.9% vs 36.3%, P = 0. 019） and large vessels atheroselerosis（44. 0% vs 28.4 %, P = 0. 003）. The differences of previous use of antithrombotic drugs between two groups were not significant （36.1% vs 35.3% ,P=0. 882）. The stroke prognosis was poor in the TIA group（modified Rankin Scale score≥4）. Multivariate Logistic regression analysis showed that the history of TIA was an independent predictor of poor prognosis in acute ischemic stroke（or：1. 47;95% ci：1. 03-2.11 ,P= 0. 042）. Conclusions TIA group has more risks of acute ischemic stroke than non-TIA group. Only one third of patients were treated with antithrombotic after TIA. The stroke patients with history of TIA were at greater risk of stroke disability.
出处
《成都医学院学报》
CAS
2012年第3期437-440,共4页
Journal of Chengdu Medical College
