短暂性脑缺血发作持续时间与后继脑梗死关系的初步研究  

Relationship between transient ischemic attack and subsequent cerebral infarction

作　　者：林晓东[1] 赵丽[1] 王学敏[1] 田小卫[1] 

机构地区：[1]河北省秦皇岛市第二医院神经内科,066600

出　　处：《中国临床实用医学》2009年第3期24-26,共3页China Clinical Practical Medicine

摘　　要：目的探讨短暂性脑缺血发作（TIA）持续时间与后继脑梗死的关系。方法2005年3月至2008年10月秦皇岛市第二医院神经内科住院患者，有TIA发作史的脑梗死（TIA组）155例，男83例，女72例，年龄36～78岁，平均（64．8±2．6）岁；依据TIA持续时间分为4个亚组：≤10min组（29例）、11～20min组（72例）、21～60min组（34例）、〉60min（20例）。合并症：高血压120例，糖尿病63例，冠心病41例。无TIA发作史的脑梗死（对照组）339例，男182例，女157例，年龄34～75岁，平均（63．5±2．2）岁，合并症：高血压275例，糖尿病137例，冠心病91例。采用脑卒中患者神经功能缺损程度评分标准和日常生活活动能力评分标准进行评分后，分析TIA的缺血预适应与TIA持续时间的关系。结果在11～20min组轻度神经功能缺损比率高（82％），Ⅰ级预后（81％），与无TIA组比较差异有统计学意义（P〈0．01）。≤10min组、2l～60min组、〉60min组和无TIA组患者神经缺损程度较严重，≤10min组Ⅰ级预后（62％）、21～60min组Ⅰ级预后（65％），〉60min Ⅰ级预后（60％），组间比较差异均无统计学意义（P〉0．01）。结论TIA的缺血预适应与TIA发作持续时间有一定关系。Objective To study the relationship between duration of transient ischemic attack （TIA） and a subsequent cerebral infarction. Methods From March 2005 to October 2008, hospital patients with cerebral infarction were selected from the Department of Neurology, the Second Hospital of Qinhuangdao. There were 155 cases cerebral infarction with TIA（ TIA group） , male of 83 cases, female of 72 cases, age between 36 to 78 years old, average （ 64. 8 ± 2. 6 ） years old ; Complications ： 120 cases with hypertention, 63 cases with diabetes,41 cases with coronary heart disease. TIA group was divided into 4 subgroups base on duration of attack ：29 cases with TIA lasting less than 10 minutes,72cases with TIA lasting 11 minutes to 20 minutes; 34 cases with TIA lasting 21 minutes tO 60 minutes and 20 cases with TIA lasting more than 60 minutes. There were 339 cases cerebral infarction without TIA （control group） ,male of 182 cases,female of 157 cases ,age between 34 to 75 years old, average 63. 5 ± 2. 2 years old; Complications ：275 cases with hypertention, 137 cases with diabetes, 91 cases with coronary heart disease. The score of neurological impairment was scored according to the score standards of China stroke scale at admittance The score of their activities of daily living were evaluated at one-month course. The relations between prognosis and the duration of TIA were analyzed. Results There was high rate （82%） of light neurological impairment and grade Ⅰ prognosis was 81% with TIA lasting 11 minutes to 20 minutes. Compared with group without TIA, there was significant difference （ P 〈 0. 01 ）. There was severe neurological impairment in other subgroup and in group without TIAs. The grade Ⅰ prognosis in the subgroup with TIA lasting less than 10 minutes ,21 minutes to 60 minutes and more than 60 minutes were 62% ,65% and 60% respectively（P 〉 0. 01 ）. Conclusion The neuroprotective effect of TIA was related to duration of TIA.

关 键 词：脑缺血发作 短暂性 脑梗死 自身耐受性 持续时间 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]