颈动脉狭窄性短暂性脑缺血进展脑梗死的相关危险因素分析  

Analysis of Related Risk Factors of Cerebral Infarction in Patients with Carotid Artery Stenosis TIA

作　　者：米国青 薛满忠 马洪颖[2] 傅昱[1] 李莉[1] Mi Guoqing Xue Manzhong Ma Hongying Fu Yu Li Li(Tangshan Ninth Hospital, Tangshan（063000）,Hebei,Chin)

机构地区：[1]河北省唐山市第九医院,河北唐山063000 [2]河北省唐山工人医院

出　　处：《中西医结合心脑血管病杂志》2017年第9期1110-1113,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：河北省科技厅计划外项目(No.20140681)

摘　　要：目的研究颈动脉狭窄性短暂性脑缺血(TIA)进展脑梗死的相关危险因素。方法选取2010年1月—2011年1月收入院并随访5年的颈动脉狭窄TIA病人129例为研究对象,根据具体情况分为试验组和对照组。试验组为继发脑梗死;对照组为无继发脑梗死。入院后,由经过训练的专人统计收集一般资料,包括年龄、性别、吸烟指数、高血压病、糖尿病;入院24h内常规抽血,检验生化指标。随访5年,统计发病情况、发病次数、时间及进展为脑梗死的时间及生化指标、格拉斯哥评分(GCS)、神经功能损害情况、日常生活量表等(ADL)情况并比较。结果试验组与对照组年龄、糖尿病、高血压病、吸烟指数、ABCD2评分比较均具有统计学意义(P<0.05),而在性别比较方面未见统计学意义(P>0.05)。入院时,两组血小板计数和纤维蛋白原比较具有统计学意义(P<0.05),其他生化指标均未见统计学意义(P>0.05)。对照组中度狭窄比例显著高于试验组(P<0.05);试验组颈动脉完全闭塞及重度狭窄病人比例显著高于对照组(P<0.05)。试验组入院时GCS评分、中重型神经功能缺损比率及出院时ADL量表得出的Ⅱ级预后比率及死亡率,均显著高于对照组(P<0.05)。试验组脑损伤程度重,预后差。结论颈动脉狭窄性TIA病人继发脑梗死的危险因素包括高龄、糖尿病、高血压、吸烟指数超过400、血小板计数及纤维蛋白原水平升高,同时颈动脉狭窄性TIA继发脑梗死,脑损伤重。Ohjectivc To investigate the risk factors of cerebral infarction in patients with carotid artery stenosis transient cerebral ischemia （TIA）.Methods One hundred and twenty nine patients with carotid artery stenosis TIA were selected as the research object, and divided into the experimental group for secondary to cerebral infarction and the control group without secondary to cerebral infarction.After admission,the general information were collected, including age, gender, smoking index, history of hypertension, history of diabetes mellitus.The biochemical indexes were tested within 24 hours after admission.After 5 years of follow up, the incidence, onset frequency, time and progress for cerebral infarction and biochemical indexes, Glasgow Coma Scale （GCS） score, nerve function damage, Activities of Daily Living （ADL） score were observed.Results There was significant difference in age, history of diabetes, hypertension, smoking index and ABCD2 score between two groups （ P 〈0.05） .There was significant difference in platelet count and fibrinogen at the time of admission between two groups （ P 〈0.05） .The proportion of patients with moderate stenosis in the control group was significantly higher than that in the experimental group （ P 〈0.05） .The proportion of the carotid artery occlusion and stenosis in the experimental group was significantly higher than that in the control group （ P 〈0.05） .The GCS score, moderate and severe neurological deficit ratio at admission and ADL derived class II prognosis rate and mortality at discharge were significantly higher than those in the control group （ P 〈0.05） .The results showed that the degree of brain injury was heavy and the prognosis was poor in the experimental group.Conclusion The risk factors in carotid artery stenosis of TIA patients with secondary cerebral infarction are age,diabetes,hypertension,smoking index more than 400,elevated platelet counts and fibrinogen levels.The carotid artery stenosis of TI

关 键 词：短暂性脑缺血 颈动脉狭窄性 脑梗死 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]