短暂性缺血发作7 d内预后的影响因素  

Prognosis factors of transient ischemic attack within 7 days

作　　者：董敏[1] 车振勇[2] 赵剑婷[2] 王慧敏[2] DONG Min;CHE Zhenyong;ZHAO Jianting;WANG Huimin(Xinxiang Medical University,He＇nan Province,Xinxiang 453000,China;Ward 2 of Department of Special,Xinxiang Central Hospital,He＇nan Province,Xinxiang 453000,China)

机构地区：[1]新乡医学院,河南新乡453000 [2]河南省新乡市中心医院特需二科,河南新乡453000

出　　处：《中国医药导报》2018年第17期61-64,共4页China Medical Herald

摘　　要：目的探讨短暂性脑缺血发作(TIA)后7 d内预后的影响因素。方法选取2015年6月~2016年6月就诊于新乡市中心医院的56例TIA患者,于发病后24 h内分别行头部灌注加权成像(PWI)和弥散加权成像(DWI)检查,DWI影像上无脑缺血改变,同时进行ABCD^2评分,随访观察患者7 d内脑梗死的发生率。结果 56例TIA患者7 d内发生脑梗死23例,发生率为41.1%;ABCD^2评分低危者7 d内脑梗死发生率低于中危和高危者,中危者低于高危者,差异均有统计学意义(P<0.05);MR-PWI检查结果阳性者7 d内脑梗死发生率明显高于阴性者,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,PWI阳性(OR=2.998、95%CI:1.456~6.172、P=0.003)、ABCD^2评分(OR=3.765、95%CI:1.193~11.878、P=0.024)、颅内血管狭窄(OR=4.743、95%CI:2.109~10.667、P=0.000)、心房颤动(OR=3.051、95%CI:1.185~7.855、P=0.021)是TIA 7 d内脑梗死发生的危险因素。结论 磁共振灌注成像阳性、ABCD^2评分、颅内血管狭窄以及心房颤动是TIA疾病预后的重要影响因素。Objective To explore the factors of affecting the prognosis after transient ischemic attack（TIA） within 7 d.Methods From June 2015 to June 2016, in Xinxiang Central Hospital, 56 patients with TIA and were examined by perfusion-weighted imaging（PWI） and diffusion-weighted imaging（DWI） within 24 hours after onset were selected,there was no cerebral ischemia in DWI images. Meanwhile, the ABCD^2 score was applied, the incidence of patients with cerebral infarction within 7 d were followed-up and observed. Results 23 cases（41.1%） had cerebral infarction in56 patients with TIA within 7 d. The incidence of cerebral infarction in the low risk group of ABCD^2 score was lower than that in the middle risk group and the high risk group within 7 d, the middle risk group was lower than the high risk group, the differences were statistically significant（P〈0.05）. The incidence of cerebral infarction in the patients with positive MR-PWI examination was significantly higher than that in the negative patients within 7 d, the differences were statistically significant（P〈0.05）. Logistic regression analysis showed that PWI positive（OR = 2.998, 95%CI： 1.456-6.172, P = 0.003）, ABCD^2 score（OR = 3.765, 95%CI： 1.193-11.878, P = 0.024）, intracranial vascular stenosis（OR = 4.743, 95% CI： 2.109-10.667, P = 0.000） and atrial fibrillation（OR = 3.051, 95% CI： 1.185-7.855, P =0.021） were risk factors of cerebral infarction of TIA within 7 d. Conclusion Positive magnetic resonance perfusion imaging, ABCD^2 score, intracranial vascular stenosis and atrial fibrillation are important prognostic factors of TIA diseases.

关 键 词：磁共振灌注成像 ABCD^2评分 短暂性脑缺血发作 脑梗死 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]