短暂性脑缺血对继发脑梗死的影响及与纤维蛋白原水平的相关性分析  

Study on the Impact of Transient Ischemic Attack on Secondary Cerebral Infarction and Its Correlation with Fibrinogen Level

作　　者：边焕茹[1] 王真[1] 刘保萍[1] 李文英[1] 郭文杰 

机构地区：[1]华北石油管理局总医院神经内科,河北任丘062552 [2]任丘市人民医院内三科,河北任丘062550

出　　处：《医学综述》2015年第2期363-364,共2页Medical Recapitulate

摘　　要：目的探讨短暂性脑缺血发作(TIA)对患者继发脑梗死的影响及与血浆纤维蛋白原水平的相关性。方法回顾性分析2010年12月至2011年12月华北石油管理局总医院收治的128例脑梗死患者的临床资料,依据1周前是否有同侧TIA发作分为TIA组(49例)和非TIA组(79例),比较两组患者的脑梗死体积、神经功能缺损程度及预后,并比较血糖、血脂、肌酐和纤维蛋白原等指标,进行脑梗死发生的多因素Logistic回归分析。结果 TIA组脑梗死体积、神经功能缺损程度、预后分级均优于非TIA组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,纤维蛋白原是TIA患者脑梗死发生的危险因素(OR=0.625,P<0.05)。结论 TIA能够减少脑梗死体积、减轻脑梗死神经功能损伤同时改善患者的预后,其机制可能与诱导脑耐受缺血,对继发脑梗死有神经保护作用相关,而纤维蛋白原可作为脑梗死独立危险因素,其水平高低能作为TIA患者预后辅助判断指标。Objective To investigate the impact of transient ischemic attack（ TIA） on secondary cerebral infarction and its correlation with fibrinogen level in plasma. Methods Clinical data of 128 cerebral infarction patients admitted in General Hospital of Huabei Petroleum Administration from Dec. 2010 to Dec.2011 was retrospectively analyzed,and all the cases were divided into TIA group（ 49 cases） and non-TIA group（ 79 cases） according to whether there was occurrence of ipsilateral TIA one week before onset. The cerebral infarction volume,neural function defect and prognosis of the two groups were compared,and indexes of blood glucose,blood lipid,creatinine and fibrinogen of the two groups were compared,multivariate Logistic regression analysis was carried out. Results In TIA group,the cerebral infarction volumn,the degree of neural function defect,and grading of prognosis were better than non-TIA group,the differences were statistically significant（ P 0. 05）; results of multivariate Logistic regression analysis showed fibrinogen was the risk factor of cerebral infarction in TIA patients（ OR = 0. 625,P 0. 05）. Conclusion TIA can reduce the cerebral infarction volumn,reduce neurological injury of cerebral infarction and improve the prognosis of the patients,the possible mechanism may be related to the induction of brain tolerance to ischemia,which may have a neuroprotective effect on secondary infarction,and fibrinogen as an independent risk factor of cerebral infarction,its level can be used as auxiliary index for prognosis evaluation of patients with TIA.

关 键 词：短暂性脑缺血发作 脑梗死 纤维蛋白原 危险因素 

分 类 号：R743.4[医药卫生—神经病学与精神病学]