后循环短暂性脑缺血发作患者临床特征及脑卒中危险因素分析

目的探讨后循环短暂性脑缺血发作（transient ischemic attacks，TIA）患者的临床特征及脑卒中危险因素，为预防脑卒中提供依据。 方法选取2010年10月至2013年12月浙江医院收治的确诊的后循环TIA患者88例，对其临床特征及相关危险因素（高血压、冠心病、糖尿病、高脂血症、房颤、吸烟）进行分析。相关性分析采用Logistic回归分析。 结果主要临床特征：年龄多≥60岁（69.3%），最常见的临床表现为头晕（44.3%），症状持续时间多在10 min以内（43.2%），TIA后脑卒中发生相关危险因素中以高血压的发生率最高（48.9%），椎基底动脉狭窄≥50%者占20.5%。随访7d内脑卒中的发生率为8%（7/88）。对6项危险因素进行Logistic回归分析，结果显示糖尿病为TIA后发生脑卒中的独立危险因素(OR=5.867，95%CI=1.186～29.014，P<0.05)。 结论后循环TIA的临床表现复杂多样，高血压是最常见的危险因素，糖尿病可能对TIA后发生脑卒中的影响更大。

The analysis of risk factors and clinical features of patients with transient ischemic attacks in posterior circulation

ObjectiveTo analyze the clinical features, risk factors and prognosis of patients with transient ischemic attacks (TIA) in posterior circulation, and provide the evidence for prevention of stroke. MethodsWe prospectively selected 88 posterior circulation TIA patients from October 2010 to December 2013, analyzed their clinical features, risk factors (hypertension, diabetes, hyperlipoidemia, coronary artery disease, atrial fibrillation and smoke). Results69.3% patients were older than 60 years. The most common feature of posterior circulation TIA patients were dizziness (44.3%) and the duration of symptoms was less than ten minutes (43.2%). The incidence of hypertension was highest (48.9%) among these risk factors. 20.5% patients had vertebrobasilar arterial stenosis≥50%. And 8% (7/88) patients suffered stroke in 7 days after TIA. The Logistic regression analysis of 6 risk factors (hypertension, diabetes, hyperlipoidemia, coronary artery disease, atrial fibrillation and smoke) showed that diabetes was the independent risk factor of the stroke after posterior circulation of TIA (OR=5.867, 95%CI: 1.186-29.014,P<0.05). ConclusionThe clinical features of patients with transient ischemic attacks (TIA) in posterior circulation were complex. Hypertension was the most common risk factor and diabetes may affect more on stroke after TIA.