老年人短暂性脑缺血发作的危险因素分析及应用氯吡格雷联合阿司匹林的疗效  

Analysis of risk factors for transient ischemic attacks in the elderly and the therapeutic effect of clopidogrel combined with aspirin

作　　者：罗春香[1] 娄秋英[1] LUO Chunxiang;LOU Qiuying(Department of Neurology,Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi,330000,China)

机构地区：[1]南昌大学第二附属医院神经内科,江西南昌330000

出　　处：《当代医学》2023年第31期95-98,共4页Contemporary Medicine

基　　金：江西省卫生计生委科技计划项目(20175256,20155263)。

摘　　要：目的分析老年人短暂性脑缺血发作(TIA)的危险因素分析及应用氯吡格雷联合阿司匹林的疗效。方法选取2019年6月至2021年5月南昌大学第二附属医院收治的120例老年TIA患者作为老年组,另选取同期住院治疗的60例青年TIA患者作为中年组,两组均给予氯吡格雷联合阿司匹林治疗。比较两组预后归转情况,并采用Log-Rank法及多元Logistic回归分析法分析预后相关危险因素。结果治疗后,中年组TIA症状发作持续时间短于老年组,发作次数少于老年组,发作频率低于老年组,差异有统计学意义(P<0.05)。治疗1周、30 d、90 d后,中年组预后良好率分别为63.33%、73.33%、83.33%,均高于老年组的34.16%、43.33%、55.00%,差异有统计学意义(P<0.05)。Log-Rank法分析结果显示,预后不良患者性别、ABCD2分级、卒中史、动脉狭窄、冠心病、糖尿病及高脂血症与预后良好患者比较差异有统计学意义(P<0.05),动脉狭窄位置、高血压与预后良好患者比较差异无统计学意义。多元Logistic回归分析结果显示,男性、ABCD2分级为高危、卒中史、动脉狭窄、冠心病、糖尿病为影响老年TIA患者预后的独立危险因素(P<0.05)。结论氯吡格雷联合阿司匹林治疗老年TIA患者疗效显著,男性、ABCD2分级为高危、卒中史、动脉狭窄、冠心病、糖尿病为影响老年TIA患者预后的独立危险因素,临床应针对上述因素做好预防工作。Objective To analyze the risk factors of transient ischemic attack(TIA)in the elderly and the efficacy of clopidogrel combined with aspirin.Method 120 elderly TIA patients admitted to the Second Affiliated Hospital of Nanchang University from June 2019 to May 2021 were se-lected as the elderly group,and 60 young TIA patients who were hospitalized during the same period were selected as the middle-aged group,the two groups were treated with clopidogrel combined with aspirin.The prognosis of the two groups was compared,and the prognostic risk factors were ana-lyzed by Log-Rank method and multivariate Logistic regression analysis.Results After treatment,the duration of TIA symptoms in middle-aged group was shorter than that in the elderly group,the number of TIA attacks was less than that in the elderly group,and the frequency of TIA attacks was lower than that in the elderly group,and the differences were statistically significant(P<0.05).After 1 week,30 d,and 90 d of treatment,the good prognosis rates in the middle-aged group were 63.33%,73.33%,and 83.33%,respectively,which were higher than the 34.16%,43.33%,and 55.00%in the elderly group,and the differences were statistical significance(P<0.05).The results of Log-Rank analysis showed that there were sig-nificant differences in gender,ABCD2 grade,stroke history,arterial stenosis,coronary heart disease,diabetes and hyperlipidemia between patients with poor prognosis and patients with good prognosis(P<0.05);there was no significant difference in the location of arterial stenosis and hyperten-sion between patients with poor prognosis and patients with good prognosis.Multivariate Logistic regression analysis showed that male,ABCD2 grade as high risk,stroke history,arterial stenosis,coronary heart disease and diabetes were independent risk factors affecting the prognosis of elderly patients with TIA(P<0.05).Conclusion Clopidogrel combined with aspirin has a significant effect in the treatment of elderly TIA patients,male,ABCD2 classified as high risk,stroke history,art

关 键 词：老年 短暂性脑缺血发作 氯吡格雷 阿司匹林 预后 危险因素 

分 类 号：R743.31[医药卫生—神经病学与精神病学]