短暂性脑缺血发作持续时间与后继脑梗死关系的临床研究

目的探讨短暂性脑缺血发作(TIA)持续时间与后继脑梗死的关系。方法选择首次入院的脑梗死患者658例,男性378例,女性280例,平均年龄(64.03±11.13)岁,按患者脑梗死前是否发生同侧TIA,将其分为无TIA组(536例)和TIA组(122例),TIA组又按持续时间分为<5 min组(20例),5~20 min组(68例),21~60 min组(26例)和>60 min组(8例)4个亚组。采用脑卒中患者神经功能缺损程度评分标准(CSS)和日常生活活动能力(ADL)评分标准进行评分后,分析TIA的缺血预适应与TIA持续时间的关系。结果在5~20 min组轻度神经功能缺损比率较高(82%),Ⅰ级预后(79%),与无TIA组比较差异均有显著性意义(P<0.05)。21~60 min组、>60 min组和无TIA组患者神经缺损程度较严重,<5 min组Ⅰ级预后(65%),21~60 min组Ⅰ级预后(62%),>60 min组Ⅰ级预后(63%),组间比较差异均无显著性意义(P>0.05)。结论TIA的缺血预适应与TIA发作持续时间有一定关系。

The clinical study on the relationship between the duration of transient ischemic attack and a subsequent cerebral infarction

Objective To study the relation between the duration of transient ischemic attack(TIA) and a subsequent cerebral infarction(CI).Methods 658 patients who were hospitalized for the first time because of CI,including 122 patients who had the prior ipsilateral TIAs before CI.According to whether they had ipsilateral TIAs in advance,these patients were divided into two groups: the group with TIAs and the group without TIAs.The relationship between neuroprotective effects of TIAs and the duration of TIA was analyzed.The score of neurologic impairment was rated according to the score standards of CSS and ADL when the patients were admitted to hospital.Results There was high rate(82%) of light neurologic impairment in the patients who had prior TIAs lasting 5 to 20 min,and their grade-Ⅰ prognosis was 79%.Compared with patients without TIAs,there was significant difference(P<0.05).There was severe neurologic impairment in the patients with prior TIAs lasting 21 to 60 minutes and longer than 60 minutes and the patients without TIAs.The grade-Ⅰ prognosis in the groups with TIA lasting less than 5 minutes was 65%,the groups with TIA lasting 21 to 60 minutes was 62% and the groups longer than 60 minutes was 63%.There were no significant differences between the three groups(P>0.05).Conclusion The neuroprotective effect of TIAs has relation with the duration of transient ischemic attack.