先兆TIA对脑梗死体积和严重度影响的临床研究  

Effect of prodromal TIA on infarction volume, clinical severity and prognosis in patients with subsequent cerebral infarction

作　　者：韩巨[1] 刘军[2] 冯亚波[3] 麻琳[4] 于战涛[5] 

机构地区：[1]山东省千佛山医院（山东大学临床医学院）神经内科,济南250014 [2]山东省济宁市第一人民医院神经内科,272111 [3]山东省立医院神经内科,济南250021 [4]山东大学齐鲁医院神经内科,济南250000 [5]山东省威海市文登中心医院神经内科,264400

出　　处：《中华神经医学杂志》2007年第1期38-40,共3页Chinese Journal of Neuromedicine

基　　金：山东省卫生厅资助课题（2001CA2DCA1）

摘　　要：目的研究先兆TIA对其后脑梗死体积和临床严重度的影响，探讨TIA的临床意义。方法采用多中心、前瞻性病例对照研究方法，对110例大脑中动脉区有先兆TIA的脑梗死患者的梗死体积、临床严重度以及预后和相同例数的单纯脑梗死患者进行比较研究。结果TIA-脑梗死组患者脑梗死体积为（2．36±1．13）cm^3，单纯脑梗死组梗死体积（3．65±2．03）cm^3，前者脑梗死体积明显小于后者（P〈0．01）；TIA-脑梗死组梗死后神经功能评分为15．45±4．10，单纯脑梗死组为21．92±4．53，前者临床严重度明显比后者轻（P〈0．01）；3个月后TIA-脑梗死组能自理82人，单纯脑梗死组能自理67人，前者预后明显好于后者（P〈0．05）。结论先兆TIA能诱导大脑产生缺血耐受，对脑梗死起保护作用，可明显减少脑梗死的体积，减轻脑梗死后的神经功能损害并改善脑梗死的预后。Objective To explore the effect ofprodromal transient ischemia attack （TIA） on infarction volume, clinical severity and prognosis in patients with subsequent cerebral infarction. Methods A multi-center prospective case-control study was performed on the infarction volume, clinical severity and prognosis of the ischemic stroke patients with or without prodromal TIA in middle artery region （n=110/group）. Results Despite no significant difference in baseline characteristics, the infarction volume in prodromal TIA group was significantly smaller than that in control group [（2.36± 1.13） cm^3 vs （3.65±2.03） cm^3, P〈0.01]; the neurological deficit scale was 15.45±4.10 in prodromal TIA group, obviously lighter than that in control group （21.92±4.53, P〈0.01）; 3 months later, 82 patients in prodromal TIA group and 67 patients in control group could live by themselves, and the prognosis was better in the former group than in the later （P〈0.05）. Conclusion Prodromal TIA probably induce cerebral ischemic tolerance in human brain and provide neuroprotection against subsequent severe ischemic stroke, thus decreasing the stroke severity and reducing its infarction volume and improving the prognosis in the patients with subsequent cerebral infarction.

关 键 词：短暂性脑缺血发作 脑梗死 缺血耐受 缺血预处理 

分 类 号：R686[医药卫生—骨科学]