短暂性脑缺血发作患者短期预后的影响因素分析

目的 探讨短暂性脑缺血发作(TIA)患者短期内进展为脑梗死的相关危险因素.方法 235例TIA患者以住院14天为观察终点,14天内进展为脑梗死的患者为进展组(n=76),未进展为脑梗死者为未进展组(n=159).分析两组间的相关因素.结果 经单因素分析筛选出有意义的影响因素为高胆固醇血症史(46.1%vs28.3%,P＜0.01)、糖尿病史(51.3%vs 31.4%,P＜0.01)、脑血管病家族史(68.4%vs 49.1%,P＜0.01)、空腹血糖升高(55.3%vs 9.4%,P＜0.01)、空腹胆固醇升高(59.2%vs 34.6%,P＜0.01)、颈动脉粥样硬化斑块(73.7%vs 56.0%,P＜0.01);多因素非条件logistic回归分析显示脑血管病家族史(OR=1.615,P＜0.01)、糖尿病史(OR=1.761,P＜0.01)是TIA患者短期内进展为脑梗死的危险因素.结论 脑血管病家族史、糖尿病史是TIA患者短期内进展为脑梗死的危险因素;TIA后患者进展为脑梗死的风险较高.

Risk factors about recent prognosis of patients with transient ischemic attack

Objective To explore the risk factors of cerebral infarction in patients with transient ischemic attack（TIA） in short term.Methods 235 patients with TIA were observed,taking 14 days in hospital as the end of observation.The patients developed to cerebral infarction were taken as deteriorated group（n=76）,others as non-deteriorated group（n=159）.The risk factors were analyzed between the two groups.Results The significant influential factors after univariate analysis were：high cholesterol（CHO） history（46.1% vs 28.3%,P0.01）,diabetes mellitus（DM） history（51.3% vs 31.4%,P0.01）,familial cerebral vascular disease history（68.4% vs 49.1%,P0.01）,high fast plasma glucose（FPG）（55.3% vs 9.4%,P0.01）,high fast CHO（59.2% vs 34.6%,P0.01）,carotid artherosclerosis（73.7% vs 56.0%,P0.01）.After analyzing by multivariate non-conditional logistic regression model analysis,the result showed that the risk factors leading TIA to cerebral infarction in short term were familial cerebral vascular disease history（OR=1.761,P0.01）,DM history（OR=1.615,P0.01）.Conclusion The risk factors leading TIA to cerebral infarction in short term are familial cerebral vascular disease history,DM history.Patients after TIA have higher risks in deteriorating to cerebral infarction.