早期临床二级干预治疗与短暂性脑缺血发作预后的关系  

Relationship Among Early Secondary Clinic Intervention Treatment and Recent Prognosis of Transient Ischemic Attack

作　　者：周智 蒲国兴 尚迟 李君[2] 孙维权[2] 

机构地区：[1]湖北省谷城县人民医院神经内科,湖北谷城441700 [2]湖北文理学院医学院,湖北襄阳441053

出　　处：《湖北文理学院学报》2015年第11期81-84,共4页Journal of Hubei University of Arts and Science

基　　金：湖北文理学院医学院与谷城县人民医院横向合作课题

摘　　要：目的：探寻早期临床二级干预治疗（降纤治疗、抗血小板治疗和抗凝治疗）与短暂性脑缺血发作（TIA）患者近期预后的关系,为TIA的预防、治疗及阻止疾病进展提供依据.方法：病例为2013年9月至2014年11月襄阳市三所医院神经内科收治的TIA患者,共224例.以住院15d为观察终点,期间进展为完全性脑卒中患者75例为进展组,未进展为完全性脑卒中患者149例为未进展组.采用自行设计TIA调查表进行调查,包括人口学特征、既往史、个人生活方式、TIA发作情况、治疗措施（降纤治疗、抗血小板治疗、抗凝治疗）等.所有数据用Excel建立数据库,应用SPSS 13.0统计软件进行数据统计分析,应用卡方检验进行因素与TIA预后关系分析.结果：224例TIA患者中,进行降纤治疗患者中17例进展为完全性脑卒中,进行非降纤治疗患者中58例进展为完全性脑卒中,降纤治疗与TIA近期预后有关联（χ2=4.911,P=0.027,OR=0.611,95%CI：0.410~0.910）,降纤治疗降低TIA患者近期进展为完全性脑卒中的危险性.抗血小板治疗、抗凝治疗与TIA近期预后无关联.结论：降纤治疗可作为预防TIA进展为完全性脑卒中的早期临床二级干预治疗措施.Objectives： To explore the relationship among early secondary clinic intervention treatment, such as defibrination therapy, antiplatelet therapy, anticoagulation therapy, and recent prognosis of Transient Ischemic Attack（TIA） to complete stroke and to provide scientific basis for prevention,therapy and obstructing disease progress of TIA. Methods： All of the TIA objects（224） came from neurology departments of three hospitals in Xiang City from September 2013 to November 2014, which have been observed for 15 days in hospital. 75 patients with complete stroke were taken as the deteriorated group, 149 patients with incomplete stroke as the non-deteriorated group. All patients were investigated by face to face interview according to the same questionnaire, which included demographic parameters, disease history, life style, attack situation of TIA, therapy measures（defibrination therapy, antiplatelet therapy, anticoagulation therapy）, and so on. The database was set up by Excel and was analyzed using the statistical software SPSS 13.0 version. Chi-square test was used to analyze the correlation between factors and TIA prognosis. Results： Of all the 224 cases, 17 cases cured with defibrination therapy deteriorated to complete stroke, and 58 cases cured without defibrination therapy deteriorated to complete stroke. There were correlation between defibrination therapy and TIA recent prognosis（χ2=4.911, P=0.027, OR=0.611, 95%CI：0.410~0.910）. Defibrination therapy reduced the risk of recent progression to complete stroke for TIA patients. There was no correlation between antiplatelet therapy, anticoagulation therapy and recent prognosis of TIA. Conclusions： Defibrination therapy may be used as early secondary clinic intervention treatment measure preventing TIA from complete stroke.

关 键 词：短暂性脑缺血发作(TIA) 完全性脑卒中 降纤治疗 抗血小板治疗 抗凝治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]