短暂性脑缺血发作的危险因素及全脑血管造影对预后评估的价值  

Risk Factors of Carotid System Transient Ischemic Attacks and Prognosis Evaluation Value of Aortocranial Angiography

作　　者：李韧[1] 赵桂梅[1] 崔丽颖[1] 张轩[1] 张希庆[1] 

机构地区：[1]中国医科大学第八临床学院鞍钢总医院神经内科,辽宁省鞍山市114002

出　　处：《中国全科医学》2010年第14期1499-1501,共3页Chinese General Practice

摘　　要：目的探讨颈动脉系统短暂性脑缺血发作(TIA)患者的血脂和血浆基质金属蛋白酶9(MMP-9)水平、颈动脉内中膜厚度(IMT)和斑块的发生率与TIA的关系及全脑血管造影对预后评估的价值。方法回顾性分析76例颈动脉系统TIA患者(病例组)的血脂和血浆MMP-9水平、颈动脉IMT及斑块发生率,并与40例健康体检者(对照组)进行对比分析;根据数字减影血管造影(DSA)检查结果确定TIA患者的治疗方案,并评估DSA对预后评估的价值。结果(1)TIA患者的血脂和血浆MMP-9水平与对照组相比差异有统计学意义(P<0.05),颈动脉IMT及斑块发生率较对照组明显升高(P<0.05),但病例组中有脑梗死亚组和无脑梗死亚组比较颈动脉IMT及斑块发生率间差异均无统计学意义(P>0.05)。(2)行DSA检查发现TIA患者脑血管狭窄发生率达80.26%(61/76),根据DSA检查结果所采取的治疗方案临床效果佳。结论血脂和血浆MMP-9水平异常、颈动脉IMT增厚和斑块形成与TIA具有相关性,是颈动脉系统TIA的高危因素;临床上可依据DSA检查结果确定治疗方案及对预后进行评估。Objective To explore the relationship of serum lipid,plasma MMP-9 levels and the incidence of carotid intima-media thickness （IMT）,plaques to TIA and the prognosis evaluation value of aortocranial angiography in patients with carotid system transient ischemic attacks （TIA）.Methods A retrospective analysis was conducted on serum lipid,plasma MMP-9 levels,the incidence of carotid IMT and plaques in 76 carotid system TIA patients.Treatment protocols of TIA patients were determined based on digital subtraction angiography （DSA） results and the value of DSA for prognosis was evaluated.Results There was significant difference in serum lipid and plasma MMP-9 levels between groups TIA and control（P〈0.05）.The incidence of carotid IMT and plaques was higher in TIA group than in control （P〈0.05）,but there was not significant difference in carotid IMT or plaque incidence between subgroups cerebral infarction （CI） and non-CI （P〈0.05）.DSA examination showed that the incidence of cerebrovascular stenosis was 80.26%（61/76）in TIA patients.The clinical effectiveness of treatment protocols based on DSA results was good.Conclusion Abnormal serum lipid,plasma MMP-9 levels,carotid IMT thickening and plaque formation,correlated with TIA,are high risk factors.Treatment protocols can be determined clinically based on DSA results and prognosis be evaluated.

关 键 词：颈动脉 短暂性脑缺血发作 基质金属蛋白酶9 血管造影术 数字减影 

分 类 号：R743.31[医药卫生—神经病学与精神病学]