颅内外血管狭窄增加短暂性脑缺血发作早期的危险

目的探讨颅内外血管狭窄对首次短暂性脑缺血发作(TIA)后早期预后的影响。方法对196例首次发作TIA的患者行脑数字减影血管造影术检查,根据是否有颅内外狭窄,将其分为颅内外血管狭窄组(狭窄组)142例和无颅内外血管狭窄组(正常组)54例,比较两组3个月内的缺血性脑卒中发生率、TIA再发率和病死率;用logistic回归分析危险因素,Kaplan-Meier生存曲线估计生存率。结果狭窄组发生TIA 22例、脑梗死21例、死亡6例、合计发病49例,正常组发生TIA 4例、脑梗死2例、死亡0例、合计发病6例。在脑梗死和合计发病率方面,两组比较差异有统计学意义(P<0.05,P<0.001);TIA再发率、病死率差异无统计学意义(P>0.05);Kaplan-Meier生存曲线比较差异有统计学意义(P<0.005)。结论颅内外血管狭窄是TIA后早期预后的独立危险因素。

Risk of early prognosis after a transient ischemic attack in patients with intracranial and carotid artery disease

Objective To quantify the risk of short-term prognosis after a TIA in patients with intracranial and carotid artery disease.Methods Data from 196 inpatients undergoing cerebrovascular angiography by DSA between January 1,2002 and December 30,2006 in our hospital were used.The patients were divided into intracranial and carotid artery stenosis group and the group without stenosis.The rates of recurrent TIA,ischemic stroke and death within 90 days after a first-recorded TIA were compared between the 2 groups.Logistic regression analysis was used to analyze the risk factors and kaplan-Meier survival curve was used to estimate the survival rate.Results In patients with intracranial and carotid artery stenosis,there were 22 cases of TIA,21 cases of cerebral infarction and 6 cases of death,with a total of 49 cases suffering from diseases or death.In the patients without intracranial and carotid artery stenosis,there were 4 cases of TIA,2 cases of cerebral infarction and no death,with a total of 6 cases siffering from diseases.The differences in cerebral infarction and total morbidity rate between the 2 groups were statistically significant(P<0.05,P<0.001),while the differences in recnrrence rate of TIA and fatality rate had no statistical significance.The difference in Kaplan-Meier curves between the two groups had statisfical significance(P<0.005).Conclusion Intracranial and carotid artery stenosis is independent risk factor for early prognosis after TIA.